MEDICARE: DR. RICHARD CHARLES LAMONICA PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	9701	NY

General Provider Information

NPI Number	:	1194835363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD CHARLES LAMONICA PH.D.

Provider Business Mailing Address
First Line	:	28 POPLAR PL
Second Line	:
City	:	GLEN COVE
State	:	NY
Zip	:	11542-1419
Country	:	US
Telephone Number	:	516-671-2273
Fax Number	:	516-625-5247

Provider Business Practice Location Address
First Line	:	70 GLEN COVE RD
Second Line	:	SUITE 201
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1726
Country	:	US
Telephone Number	:	516-625-5247
Fax Number	:	516-625-5247

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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