Basic Information
| Provider Information | |||||||||
| NPI: | 1558457911 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEMONS | ||||||||
| FirstName: | LORRAINE | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 711 TROY SCHENECTADY RD STE 203 | ||||||||
| Address2: | |||||||||
| City: | LATHAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121102461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187823700 | ||||||||
| FaxNumber: | 5187823799 | ||||||||
| Practice Location | |||||||||
| Address1: | 6 EXECUTIVE PARK DR | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122033791 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5186416319 | ||||||||
| FaxNumber: | 5186416850 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 01/18/2018 | ||||||||
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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 | 208000000X | 220865 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 050207000049 | 01 | NY | FIDELIS | OTHER | 000498653002 | 01 | NY | BSNENY | OTHER | 02165951 | 05 | NY | MEDICAID | 364825 | 01 | NY | MVP | OTHER | 200107 | 01 | NY | SENIOR WHOLE HEALTH | OTHER | 76906 | 01 | NY | GHI/HMO | OTHER | 10054284 | 01 | NY | CDPHP | OTHER | 582141 | 01 | NY | EMPIRE BC | OTHER | 7661249 | 01 | NY | AETNA | OTHER |