Provider Demographics
NPI:1023892486
Name:LAGARES, NATALIE ROSE (NP)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ROSE
Last Name:LAGARES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 310
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-0310
Mailing Address - Country:US
Mailing Address - Phone:516-663-6400
Mailing Address - Fax:
Practice Address - Street 1:200 GARDEN CITY PLZ STE 100
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3337
Practice Address - Country:US
Practice Address - Phone:516-663-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF349096363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily