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LORAINE IPPOLITO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
3675 SOUTHWESTERN BLVD, ORCHARD PARK, NY 14127-1732
(716) 972-0279
(716) 972-0271
Mailing address
3675 SOUTHWESTERN BLVD, ORCHARD PARK, NY 14127-1732
(716) 972-0279
(716) 972-0271

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F3002671
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00021054902
UNIVERA
NY
01
00021054903
UNIVERA
NY
01
000560087007
BC/BS
NY
01
000560087008
BCBS
NY
05
02794365
NY
01
040426002812
FIDELIS CARE #
NY
01
180048BJ
PREFERRED CARE
NY
01
9513162
IHA #
NY
Enumeration date
04/28/2006
Last updated
11/05/2015
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