# ON THE GO NP IN ADULT HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366153199
- **Authorized official:** LAURIE LUCAS DNP, NP-C (NURSE PRACTITIONER/ CEO)
- **Authorized official phone:** (718) 413-8168

## Contact information

- **Practice address:** 130 S FORDHAM RD, HICKSVILLE, NY 11801-6000
- **Practice address phone:** (516) 522-5500
- **Mailing address:** 442 S OYSTER BAY RD \# 1020, HICKSVILLE, NY 11801-3515
- **Mailing address phone:** (718) 413-8168

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/13/2022
- **Last updated:** 12/13/2022