Provider Demographics
NPI:1871735472
Name:MASONE, LORRAINE MICHELLE (LPN)
Entity type:Individual
Prefix:MISS
First Name:LORRAINE
Middle Name:MICHELLE
Last Name:MASONE
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 1:674B DEER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-1320
Mailing Address - Country:US
Mailing Address - Phone:631-482-8612
Mailing Address - Fax:
Practice Address - Street 1:674B DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-1320
Practice Address - Country:US
Practice Address - Phone:631-482-8612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225353164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse