Provider Demographics
NPI:1467607044
Name:LAMPARELLO, KRISTIN MARY (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:MARY
Last Name:LAMPARELLO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 LINCOLN AVE
Mailing Address - Street 2:SUITE # 3
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-5740
Mailing Address - Country:US
Mailing Address - Phone:516-543-8956
Mailing Address - Fax:
Practice Address - Street 1:80 LINCOLN AVE
Practice Address - Street 2:SUITE # 3
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5740
Practice Address - Country:US
Practice Address - Phone:516-543-8956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017236-1103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral