Kimberly Jane Lake, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

341106 Issued in NY

Practice address

250 W 89TH St
Apartment 11F
New York, NY 10024-1700

Phone

(917) 533-8301

NPI assigned

Dec 3, 2016

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

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1480723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480723200000",
    "number": "1821532250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 89TH ST",
            "address_2": "APARTMENT 11F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100241700",
            "telephone_number": "917-533-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W 89TH ST",
            "address_2": "APARTMENT 11F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100241700",
            "telephone_number": "917-533-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "KIMBERLY",
        "middle_name": "JANE",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-03",
        "last_updated": "2016-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "341106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikita Lakdawala, MD
• Viraj Sharad Lakdawala, MD
• Alexandria Lake, LMHC
• Danielle Lake
• Diana E Lake, MD
• Kimberly Marie Lake, MA
• Chana Lakein
• Melissa Lakes
• Nicholas Lakhan
• Divya Lakhaney, MD

• Family Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2016; 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.