Kimberky Lanza COTA/L

NPI 1730497884 - Contractor - 171W00000X

NPI Details
NPI 1730497884
Gender Female
Enumeration Date 09/22/2010
Last Updated 09/22/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
1 BRANDYWINE DR
DEER PARK NY, 11729-5721, US
Phone (631) 362-0081
Fax
Business Location
48 BURNEY BLVD
MASTIC NY, 11950-1304, US
Phone (631) 281-1517
Fax
Toxanomy
Taxonomy Code 171W00000X
License State New York
License Number 007357-1
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According to our database, Kimberky Lanza COTA/L NPI is 1730497884, taxonomy code is 171W00000X and license number is 007357-1, license state is located at New York. Kimberky Lanza COTA/L physically located at 1 Brandywine Dr, Deer Park NY, 11729-5721. NPI Number Kimberky Lanza COTA/L has the Individual type.

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1730497884 NPI number is provided on an as is basis without warranty of any kind. 1730497884 is maintained by the National Plan & Provider Enumeration System. The contents of Kimberky Lanza COTA/L are for informational purposes only.