Individual
LAUREN PERSICHETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 E 104TH ST, NEW YORK, NY 10029-4402
(212) 289-4872
Mailing address
25 E 104TH ST, NEW YORK, NY 10029-4402
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
PRO43514-1
NY
Other
Enumeration date
10/10/2012
Last updated
10/10/2012
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