Provider Demographics
NPI:1245306356
Name:LAMENDOLA, PAULA (AUD)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:
Last Name:LAMENDOLA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:PAULA
Other - Middle Name:MARIE
Other - Last Name:FUELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:175 JERICHO TPKE STE 103
Mailing Address - Street 2:SYOSSET SPEECH & HEARING CENTER
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4501
Mailing Address - Country:US
Mailing Address - Phone:516-364-1234
Mailing Address - Fax:516-364-3132
Practice Address - Street 1:175 JERICHO TPKE STE 103
Practice Address - Street 2:SYOSSET SPEECH & HEARING CENTER
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4501
Practice Address - Country:US
Practice Address - Phone:516-364-1234
Practice Address - Fax:516-364-3132
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000906231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYM01892Medicare ID - Type Unspecified
NYM01891Medicare ID - Type Unspecified