Healthcare Provider Details

I. General information

NPI: 1336073956
Provider Name (Legal Business Name): JEDZIA LAMY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1342 56TH ST
BROOKLYN NY
11219-4616
US

IV. Provider business mailing address

1342 56TH ST
BROOKLYN NY
11219-4616
US

V. Phone/Fax

Practice location:
  • Phone: 718-864-0048
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number928411-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: