Provider Demographics
NPI:1174902126
Name:POYNTER COMBS, LAUREN (LPN)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:POYNTER COMBS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 121ST ST
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-1150
Mailing Address - Country:US
Mailing Address - Phone:516-784-0760
Mailing Address - Fax:
Practice Address - Street 1:416 121ST ST
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-1150
Practice Address - Country:US
Practice Address - Phone:516-784-0760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-22
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3132171164W00000X
NY799715-01163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No164W00000XNursing Service ProvidersLicensed Practical Nurse