Basic Information
| Provider Information | |||||||||
| NPI: | 1982743373 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LUND | ||||||||
| FirstName: | ELAINE | ||||||||
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| Credential: | NP, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5548 COUNTY ROAD 32 | ||||||||
| Address2: | |||||||||
| City: | NORWICH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 138153437 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | SUNY CORTLAND | ||||||||
| Address2: | VAN HOESEN HALL, ROOM B-26 | ||||||||
| City: | CORTLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077534812 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 001336-1 | NY | X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363LF0000X | F330447-1 | NY | X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.