Provider Demographics
NPI:1679995146
Name:LAMA, MICHAEL (RPSGT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:LAMA
Suffix:
Gender:M
Credentials:RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 N BATH AVE
Mailing Address - Street 2:APT C6
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-6431
Mailing Address - Country:US
Mailing Address - Phone:732-337-4833
Mailing Address - Fax:
Practice Address - Street 1:51 N BATH AVE
Practice Address - Street 2:APT C6
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6431
Practice Address - Country:US
Practice Address - Phone:732-337-4833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ13302246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other