Provider Demographics
NPI:1215160544
Name:BALL-LANZA, DANIELA (MS)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:BALL-LANZA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:
Other - Last Name:LANZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:275 BELMORE WAY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-2372
Mailing Address - Country:US
Mailing Address - Phone:585-478-8919
Mailing Address - Fax:
Practice Address - Street 1:138 S UNION ST STE 1&2
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1351
Practice Address - Country:US
Practice Address - Phone:585-478-8919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019107-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY30-0213081OtherTAX ID