Provider Demographics
NPI:1235117078
Name:LAMONICA, JOANNE MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:MARY
Last Name:LAMONICA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 HOSPITAL DR STE 201
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-4568
Mailing Address - Country:US
Mailing Address - Phone:707-462-1928
Mailing Address - Fax:
Practice Address - Street 1:260 HOSPITAL DR STE 201
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-4568
Practice Address - Country:US
Practice Address - Phone:707-462-1928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY201950208800000X
CAC54236208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02470280Medicaid
NY02470280Medicaid
NY3S2731Medicare ID - Type Unspecified
NYH35235Medicare UPIN