Provider Demographics
NPI:1144458043
Name:L3 AGENCY
Entity type:Organization
Organization Name:L3 AGENCY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:JENIELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-300-2740
Mailing Address - Street 1:116 W 23RD ST FL 5-218
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2599
Mailing Address - Country:US
Mailing Address - Phone:646-375-2342
Mailing Address - Fax:
Practice Address - Street 1:116 W 23RD ST FL 5-218
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2599
Practice Address - Country:US
Practice Address - Phone:646-375-2342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:L3 AGENCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY542303251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care