Healthcare Provider Details

I. General information

NPI: 1235117078
Provider Name (Legal Business Name): JOANNE MARY LAMONICA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2605 KINARD ST STE 105
NEWBERRY SC
29108-2965
US

IV. Provider business mailing address

2605 KINARD ST STE 105
NEWBERRY SC
29108-2965
US

V. Phone/Fax

Practice location:
  • Phone: 803-945-4140
  • Fax: 803-345-4139
Mailing address:
  • Phone: 803-945-4140
  • Fax: 803-345-4139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number94073
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberC54236
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number201950
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: