Provider Demographics
NPI:1144509845
Name:BALDANZA, LORI C (FNP)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:C
Last Name:BALDANZA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 ATWELL RD
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-1301
Mailing Address - Country:US
Mailing Address - Phone:607-547-3480
Mailing Address - Fax:607-547-5034
Practice Address - Street 1:1 FOXCARE DR STE 308
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2086
Practice Address - Country:US
Practice Address - Phone:607-432-1163
Practice Address - Fax:607-431-5367
Is Sole Proprietor?:No
Enumeration Date:2011-08-11
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336911-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily