Individual
LAUREN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5645 MAIN ST, FLUSHING, NY 11355-5045
(718) 670-2000
Mailing address
91 MAPLE HILL RD, HUNTINGTON, NY 11743-2131
(516) 628-3443
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
021830
NY
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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