Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 632693-1 | NY |
NPI | 1235566266 |
---|---|
Provider Name | Lauren Elizabeth Brancato |
First Address | Bridgeport, NY 13030-9601 |
Second Address | Bridgeport, NY 13030-9601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2013 |
Last Update Date | 30/12/2021 |