Healthcare Provider Details

I. General information

NPI: 1376566364
Provider Name (Legal Business Name): LINDA S. LAMARCA, PH.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/15/2023
Certification Date: 07/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 GLEN HEAD RD STE 3EAST
GLEN HEAD NY
11545-1433
US

IV. Provider business mailing address

30 GLEN HEAD RD STE 3EAST
GLEN HEAD NY
11545-1433
US

V. Phone/Fax

Practice location:
  • Phone: 516-299-9300
  • Fax: 516-299-9299
Mailing address:
  • Phone: 516-299-9300
  • Fax: 516-299-9299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number017408
License Number StateNY

VIII. Authorized Official

Name: DR. LINDA S. LAMARCA
Title or Position: OWNER
Credential: PHD
Phone: 516-299-9300