Provider Demographics
NPI:1194835363
Name:LAMONICA, RICHARD CHARLES (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CHARLES
Last Name:LAMONICA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:28 POPLAR PL
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-1419
Mailing Address - Country:US
Mailing Address - Phone:516-671-2273
Mailing Address - Fax:516-625-5247
Practice Address - Street 1:70 GLEN COVE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1726
Practice Address - Country:US
Practice Address - Phone:516-625-5247
Practice Address - Fax:516-625-5247
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9701103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV97291Medicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST