LAUREN C DERRICK (NPI# 1669470951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669470951 |
| Entity Type | Individual |
| Full Name | LAUREN C DERRICK |
| Credential | NP |
| Practice Address |
5112 W Taft Rd Ste J Liverpool NY 13088-4866 |
| Mailing Address |
510 Towne Dr Fayetteville NY 13066-1331 |
| Practice Telephone | 3157012170 |
| Practice Fax Number | 3157012185 |
| Mailing Telephone | 3156630500 |
| Mailing Fax Number | 3156630514 |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2019-09-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
301621 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01980230 | 05 |
| Street Address |
5112 W TAFT RD STE J |
| City | LIVERPOOL |
| State | NY |
| Zip Code | 13088-4866 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376541730 | Larry S Charlamb | Internal Medicine | 5112 W Taft Rd Ste J, Liverpool, NY 13088-4866 | 2005-07-11 |
| 1427619527 | Justin M Kurtz | Nurse Practitioner | 5112 W Taft Rd Ste J, Liverpool, NY 13088-4866 | 2019-06-28 |
| 1316202526 | Michelle L. Depalmo | Nurse Practitioner | 5112 W Taft Rd Ste J, Liverpool, NY 13088-4866 | 2012-07-13 |
| 1871727297 | Dana Christopher Aiello | Internal Medicine | 5112 W Taft Rd Ste J, Liverpool, NY 13088-4866 | 2009-05-13 |
| 1821098625 | Matthew S Ohern | Internal Medicine | 5112 W Taft Rd Ste J, Liverpool, NY 13088-4866 | 2005-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245878966 | Anthony Edward Blumetti | Psychologist | 5100 W. Taft Road, Suite 3b, Liverpool, NY 13088 | 2019-12-12 |
| 1609350016 | Alice Nellenbach | Physical Therapy Assistant | 346 Electronics Pkwy, Liverpool, NY 13088 | 2018-09-20 |
| 1043741457 | Dawn Marie Thomas | Licensed Practical Nurse | 212 Old Liverpool Road, Building 7 Apartment 6, Liverpool, NY 13088 | 2017-03-27 |
| 1154775633 | Arielle L Leonard | Massage Therapist | 609 7th N. Street, Suite 2, Liverpool, NY 13088 | 2016-04-20 |
| 1942664362 | Accessibility Solutions, Inc. | Contractor | 115 Luther Avenue, Liverpool, NY 13088 | 2016-04-12 |
| 1497176333 | Sergey Golovko | Psychiatry & Neurology | 125 Sun Harbor Dr, Liverpool, NY 13088 | 2013-12-19 |
| 1205275286 | Brandon William Crandall | Nurse Practitioner | 5100 West Taft Rd., Suite 1c, Liverpool, NY 13088 | 2013-06-23 |
| 1184976805 | Audrey Irene Tyszka | Social Worker | 5100 W Taft Rd Ste 1f, Liverpool, NY 13088 | 2012-10-04 |
| 1790049096 | Kelley Beth Burt | Speech-Language Pathologist | 110 Elwood Davis Road, Liverpool, NY 13088 | 2012-07-02 |
| 1811288954 | Nedim Ruhotina | Urology | 100 Metropolitan Park Drive, Suite 100, Liverpool, NY 13088 | 2011-04-24 |
| Find all providers in zip 13088 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518021443 | Karen Sue Pulvino | Nurse Practitioner | 3585 Redhead Ter, Liverpool, NY 13090-1083 | 2006-12-22 |
| 1639164346 | Margaret A Donovan | Nurse Practitioner | 7449 Morgan Rd, Liverpool, NY 13090-3973 | 2005-09-19 |
| 1962925495 | Jana Dosztan-reiss, Inc. | Nurse Practitioner | 4800 Bear Rd, Liverpool, NY 13088-4604 | 2017-07-17 |
| 1629125976 | Jana Marie Dosztan-reiss | Nurse Practitioner | 4800 Bear Rd, Liverpool, NY 13088-4604 | 2007-01-05 |
| 1952392656 | Catherine Powell | Nurse Practitioner | 4820 W Taft Rd, Suite 208, Liverpool, NY 13088-2800 | 2005-11-02 |
| 1992791743 | Tina Winter | Nurse Practitioner | 4820 W Taft Rd, Suite 209, Liverpool, NY 13088-2800 | 2005-09-26 |
| 1538155387 | Dana Zaborowski | Nurse Practitioner | 4820 W Taft Rd, Suite 209, Liverpool, NY 13088-2800 | 2005-09-26 |
| 1841284064 | Sara L Gleasman-desimone | Nurse Practitioner | 5112 W Taft Rd, Suite H, Liverpool, NY 13088-4868 | 2005-09-02 |
| 1578564548 | Megan C Cross | Nurse Practitioner | 5100 W Taft Rd, Suite 4j, Liverpool, NY 13088-3807 | 2005-08-02 |
| 1780683979 | Scott D Mendzef | Nurse Practitioner | 5100 W Taft Rd, Suite 4j, Liverpool, NY 13088-3807 | 2005-07-19 |
| Find all providers in LIVERPOOL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.