Provider Demographics
NPI:1376203521
Name:LAMADIEU, BELLO (RRT)
Entity Type:Individual
Prefix:
First Name:BELLO
Middle Name:
Last Name:LAMADIEU
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 BALFOUR ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1528
Mailing Address - Country:US
Mailing Address - Phone:516-850-7516
Mailing Address - Fax:
Practice Address - Street 1:935 BALFOUR ST
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-1528
Practice Address - Country:US
Practice Address - Phone:516-850-7516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY85-4018917OtherNYS
NY85-4018917Medicaid