Organization
ON THE GO NP IN ADULT HEALTH
Active
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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