Provider Demographics
NPI:1942454558
Name:KATZMAN, LANEYA
Entity Type:Individual
Prefix:MRS
First Name:LANEYA
Middle Name:
Last Name:KATZMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:LANEYA
Other - Middle Name:
Other - Last Name:FESCINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1031
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-0031
Mailing Address - Country:US
Mailing Address - Phone:516-639-5999
Mailing Address - Fax:631-667-0145
Practice Address - Street 1:125 E 2ND ST
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-5304
Practice Address - Country:US
Practice Address - Phone:516-639-5999
Practice Address - Fax:631-667-0145
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY24161222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist