Provider Demographics
NPI:1871158295
Name:LAKHARAM, FELICIA (LPN)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:LAKHARAM
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 1:526 CALHOUN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-2808
Mailing Address - Country:US
Mailing Address - Phone:347-403-8376
Mailing Address - Fax:
Practice Address - Street 1:526 CALHOUN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2808
Practice Address - Country:US
Practice Address - Phone:347-403-8376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-01
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317028164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse