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Individual

REBECCA LAMANNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Contact information

Practice address
1184 STATE ROUTE 50, BALLSTON LAKE, NY 12019-1923
(518) 384-1281
(518) 384-0321
Mailing address
711 TROY SCHENECTADY RD, SUITE 201, LATHAM, NY 12110-2442
(518) 782-3700
(518) 782-3799

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
382647
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04474677
NY
Enumeration date
07/07/2016
Last updated
12/27/2016
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