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Organization

ON THE GO NP IN ADULT HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAURIE LUCAS DNP, NP-C (NURSE PRACTITIONER/ CEO)
(718) 413-8168
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
12/13/2022
Last updated
12/13/2022
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