Provider Demographics
NPI:1336038918
Name:LEGASPI, SHAMTA LORENZO
Entity type:Individual
Prefix:
First Name:SHAMTA
Middle Name:LORENZO
Last Name:LEGASPI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16216 78TH RD
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1917
Mailing Address - Country:US
Mailing Address - Phone:347-969-2757
Mailing Address - Fax:
Practice Address - Street 1:16216 78TH RD
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1917
Practice Address - Country:US
Practice Address - Phone:347-969-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator