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Lara Maria West

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

475 Seaview Ave, Staten Island, NY 10305-3436

PECOS Enrollment

This provider is enrolled in PECOS as LARA WEST.

Based on the most recent information from CMS, provider Lara Maria West is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1265755979
Provider Type
Individual
Full Name
West, Lara Maria
Title
Mrs.
Credential
P.A.

Gender
Female
Sole Proprietor
No
Enumeration Date
3/9/2010
Last Updated
2/13/2016

Contact Information

Practice Location

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-9158

Unlisted Fax

Mailing Location

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-9158

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 013870 New York
Code 363AM0700X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 25MP00235600 New Jersey

Lara Maria West

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Rakvin, Magdalena

Salickram, Ravi R

Yevtukhov, Allen

Frasca, Francesca Marie

Guarnera, Grazia

Mendoza, Patricia Ann

Bedard, Lindsey

Rasile, Jacqueline Marie

Olinsky, Melanie

Efendija, Betim