1881751493 NPI number — MRS. LOIS ANN RISS LSCW

Table of content: MRS. LOIS ANN RISS LSCW (NPI 1881751493)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881751493 NPI number — MRS. LOIS ANN RISS LSCW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RISS
Provider First Name:
LOIS
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LSCW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881751493
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
131 MIDGELY DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HEWLETT
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11557
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-295-5485
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6200 REV JOSEPH H MAY DRIVE BCH CHANNEL DRIVE
Provider Second Line Business Practice Location Address:
JOSEPH P ADDABBO FAMILY HEALTH CENTER
Provider Business Practice Location Address City Name:
ARVERNE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11692-1409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-945-7150
Provider Business Practice Location Address Fax Number:
718-634-4838
Provider Enumeration Date:
01/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  32248 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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