Provider Demographics
NPI:1851989032
Name:LAMAIDA, ANDREA (LMT)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:LAMAIDA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:LAMAIDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:84 HAWTHORNE RD
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-3242
Mailing Address - Country:US
Mailing Address - Phone:516-885-1933
Mailing Address - Fax:
Practice Address - Street 1:1215 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1300
Practice Address - Country:US
Practice Address - Phone:516-885-1933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013076225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist