Provider Demographics
NPI:1932977584
Name:RAIMONDI, STEPHANIE LYNNE (PMHNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LYNNE
Last Name:RAIMONDI
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:LYNNE
Other - Last Name:MCDONELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:389 GETZVILLE RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-2521
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:389 GETZVILLE RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-2521
Practice Address - Country:US
Practice Address - Phone:716-830-8915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY404719363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty