Provider Demographics
NPI:1053681551
Name:LAMOTHE, ANNE-MARIE (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:ANNE-MARIE
Middle Name:
Last Name:LAMOTHE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1642 LYDIA AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4424
Mailing Address - Country:US
Mailing Address - Phone:516-568-9051
Mailing Address - Fax:516-612-3054
Practice Address - Street 1:1642 LYDIA AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-4424
Practice Address - Country:US
Practice Address - Phone:516-568-9051
Practice Address - Fax:516-612-3054
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-31
Last Update Date:2011-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6946438163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool