Provider Demographics
NPI:1669241188
Name:KATSARAS, LEMONIA
Entity type:Individual
Prefix:
First Name:LEMONIA
Middle Name:
Last Name:KATSARAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BARSTOW RD APT 6J
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3548
Mailing Address - Country:US
Mailing Address - Phone:516-205-7946
Mailing Address - Fax:
Practice Address - Street 1:109 WHISTLER RD
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-2839
Practice Address - Country:US
Practice Address - Phone:516-627-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist