Lori S Randolph, M.S.ED

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1679782 Issued in NY

Practice address

12 Evergreen LN
Suite 1
Walden, NY 12586-1662

Phone

(718) 502-5298

NPI assigned

Jul 16, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1780939835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 EVERGREEN LN",
            "address_2": "SUITE 1",
            "city": "WALDEN",
            "state": "NY",
            "postal_code": "125861662",
            "telephone_number": "718-502-5298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 EVERGREEN LN",
            "address_2": "SUITE 1",
            "city": "WALDEN",
            "state": "NY",
            "postal_code": "125861662",
            "telephone_number": "718-502-5298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "LORI",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "M.S.ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1679782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Popo Filigrana
• Ingeborg Porco
• Susan S Qu, RPH
• Edgard Quinones, MD
• Patricia J Quinones, PHYSICIAN ASSISTANT
• Michael C Raucci, D.C., D.I.B.C.N.
• Crystle Regulbuto, MS IN EDUCATION
• Shanita Michelle Reynolds, RN,MSN,CMSRN,NE-BC
• Lorina Robles
• Ellen Sue Rodas, SLP MS CCC

• Behavior Analyst in Walden, NY
• Providers in Walden, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.