Basic Information
| Provider Information | |||||||||
| NPI: | 1497811632 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OMRANI | ||||||||
| FirstName: | LALEH | ||||||||
| MiddleName: | RACHEL | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | RPA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 BELLINGHAM LN | ||||||||
| Address2: | |||||||||
| City: | GREAT NECK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110231302 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 462 1ST AVE | ||||||||
| Address2: | DEPARTMENT OF SURGERY ON 15SOUTH | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100169196 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125623917 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/30/2006 | ||||||||
| LastUpdateDate: | 11/30/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 011263 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.