Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 259359 | MA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | F336603 | NY |
NPI | 1003057373 |
---|---|
Provider Name | Lucinda T Langenkamp |
First Address | New York, NY 10010 |
Second Address | Brooklyn, NY 11206-2501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2009 |
Last Update Date | 22/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00695941 | (05) | NY |