Provider Demographics
NPI:1477554533
Name:LAMONT, JUSTIN G (MD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:G
Last Name:LAMONT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 1ST AVE
Mailing Address - Street 2:SUITE 5D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:212-263-7186
Mailing Address - Fax:212-263-1025
Practice Address - Street 1:530 1ST AVE
Practice Address - Street 2:SUITE 5D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-7186
Practice Address - Fax:212-263-1025
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142981174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY133936687OtherUPN ELITE
NY13835UOtherAETNA
NY4227117AOtherAETNA US HEALTHCARE
NY0900571OtherUNITED HEALTHCARE - MEDIC
NYNS4386OtherOXFORD
NY139062OtherUNITED HEALTH CARE
NY0468622005OtherCIGNA
NY0M0419OtherHEALTH NET
NY13835UOtherAETNA
NY0M0419OtherHEALTH NET