Provider Demographics
NPI:1386824639
Name:LAMANNA, PETER MICHAEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:MICHAEL
Last Name:LAMANNA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 SUNDEW DR
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-5083
Mailing Address - Country:US
Mailing Address - Phone:518-357-0949
Mailing Address - Fax:
Practice Address - Street 1:41 HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3408
Practice Address - Country:US
Practice Address - Phone:518-426-2976
Practice Address - Fax:518-427-2431
Is Sole Proprietor?:No
Enumeration Date:2007-11-04
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034804183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist