Provider Demographics
NPI:1942682190
Name:GIANNETTI, LAMARA
Entity Type:Individual
Prefix:
First Name:LAMARA
Middle Name:
Last Name:GIANNETTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAMARA
Other - Middle Name:
Other - Last Name:GIANNETTI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2705 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-4101
Mailing Address - Country:US
Mailing Address - Phone:516-771-0908
Mailing Address - Fax:
Practice Address - Street 1:2705 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-4101
Practice Address - Country:US
Practice Address - Phone:516-771-0908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY609672163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse