Provider Demographics
NPI:1902628795
Name:L KANDERS NP IN ADULT HEALTH PLLC
Entity type:Organization
Organization Name:L KANDERS NP IN ADULT HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURAINE
Authorized Official - Middle Name:F
Authorized Official - Last Name:KANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:516-455-3630
Mailing Address - Street 1:7 SOMERSET DR S
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11020-1821
Mailing Address - Country:US
Mailing Address - Phone:516-455-3630
Mailing Address - Fax:
Practice Address - Street 1:7 SOMERSET DR S
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11020-1821
Practice Address - Country:US
Practice Address - Phone:516-455-3630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty