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Individual

ELLEN LAWRENCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
234 EUGENIO MARIA DE HOSTO BLVD, BRONX, NY 10451-5504
(718) 579-5000
Mailing address
2129 BUSSING AVE, BRONX, NY 10466-2136

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
605996-1
NY
363LF0000X
Family Nurse Practitioner
Primary
F339201-1
NY

Other

Enumeration date
05/19/2019
Last updated
05/19/2019
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