NPI 1730497884

Kimberky Lanza, COTAL

Practitioner Contractor Deer Park, NY

Practice location

Address: 1 Brandywine Dr, Deer Park, NY 11729-5721
Phone: (631) 362-0081
Mailing address: 48 Burney Blvd, Mastic, NY 11950-1304

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence 007357-1 (NY)

Other Contractor providers in New York →

Registry record

NPI: 1730497884
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Sep 2010
Record last updated: 22 Sep 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.