Provider Demographics
NPI:1457417719
Name:LA MONICA, AVEMARIA ALESSANDRA (PHD)
Entity Type:Individual
Prefix:DR
First Name:AVEMARIA
Middle Name:ALESSANDRA
Last Name:LA MONICA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:70 GLEN COVE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1726
Mailing Address - Country:US
Mailing Address - Phone:516-621-8211
Mailing Address - Fax:718-227-5932
Practice Address - Street 1:70 GLEN COVE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1726
Practice Address - Country:US
Practice Address - Phone:516-621-8211
Practice Address - Fax:718-227-5932
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008222-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00936181Medicaid
NY00936181Medicaid