Provider Demographics
NPI:1003363730
Name:LAMZINA, TATYANA
Entity Type:Individual
Prefix:
First Name:TATYANA
Middle Name:
Last Name:LAMZINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 BAY PKWY
Mailing Address - Street 2:5C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-1955
Mailing Address - Country:US
Mailing Address - Phone:917-539-7073
Mailing Address - Fax:
Practice Address - Street 1:7901 BAY PKWY
Practice Address - Street 2:5C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-1955
Practice Address - Country:US
Practice Address - Phone:917-539-7073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-11
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY612602163W00000X
NY115835367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse