Provider Demographics
NPI:1629348370
Name:LATERZA OZAROWSKI, AMANDA (MS)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:LATERZA OZAROWSKI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:LATERZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:211 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3661
Mailing Address - Country:US
Mailing Address - Phone:516-639-7223
Mailing Address - Fax:
Practice Address - Street 1:333 LUDLOW ST
Practice Address - Street 2:NORTH TOWER, 8TH FLOOR
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-0690
Practice Address - Country:US
Practice Address - Phone:800-298-6470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS