Provider Demographics
NPI:1801957618
Name:LAMANNA, MARIA (CRNA)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:LAMANNA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:LAMANNA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:675 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-3909
Mailing Address - Country:US
Mailing Address - Phone:516-978-3826
Mailing Address - Fax:
Practice Address - Street 1:10 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5214
Practice Address - Country:US
Practice Address - Phone:914-637-3510
Practice Address - Fax:914-819-0061
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY476975367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
A400012797Medicare PIN
NYA400002300Medicare PIN
NYR0C711Medicare PIN
NYA400013271Medicare PIN
NY0650ATMedicare PIN