Provider Demographics
NPI:1679026306
Name:LENANE, BRIDGET KATHLEEN (RN)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:KATHLEEN
Last Name:LENANE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:KATHLEEN
Other - Last Name:CAREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:15 SUFFERN PLACE
Mailing Address - Street 2:STE A
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901
Mailing Address - Country:US
Mailing Address - Phone:845-357-4500
Mailing Address - Fax:845-357-5039
Practice Address - Street 1:15 SUFFERN PLACE
Practice Address - Street 2:STE A
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901
Practice Address - Country:US
Practice Address - Phone:845-357-4500
Practice Address - Fax:845-357-5039
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY704069163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse