Provider Demographics
NPI:1578046140
Name:LEMONDA, MARY ANN N
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ANN N
Last Name:LEMONDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-2113
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:549 CONCORD AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON PK
Practice Address - State:NY
Practice Address - Zip Code:11596-2113
Practice Address - Country:US
Practice Address - Phone:516-248-0566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst