Provider Demographics
NPI:1376921676
Name:LOWE, LORI-ANN
Entity type:Individual
Prefix:
First Name:LORI-ANN
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 NEW YORK AVE
Mailing Address - Street 2:APT 6F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-6156
Mailing Address - Country:US
Mailing Address - Phone:646-388-0191
Mailing Address - Fax:
Practice Address - Street 1:1304 NEW YORK AVE
Practice Address - Street 2:APT 6F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-6156
Practice Address - Country:US
Practice Address - Phone:646-388-0191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY925431161174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist