Provider Demographics
NPI:1669938676
Name:LAMANNA, TAMMY THERESA (LPN)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:THERESA
Last Name:LAMANNA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:TAMMY
Other - Middle Name:THERESA
Other - Last Name:ASARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:313 SNOWDALE DRIVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13209
Mailing Address - Country:US
Mailing Address - Phone:315-243-6493
Mailing Address - Fax:315-255-3872
Practice Address - Street 1:313 SNOWDALE DRIVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13209
Practice Address - Country:US
Practice Address - Phone:315-243-6493
Practice Address - Fax:315-255-3872
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239416-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse