Provider Demographics
NPI:1386326668
Name:LAMONTE, KEELEY LYNN (TATTOO ARTIST)
Entity type:Individual
Prefix:
First Name:KEELEY
Middle Name:LYNN
Last Name:LAMONTE
Suffix:
Gender:F
Credentials:TATTOO ARTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 STERLING AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-2445
Mailing Address - Country:US
Mailing Address - Phone:716-578-4888
Mailing Address - Fax:
Practice Address - Street 1:142 BIDWELL PKWY
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-1164
Practice Address - Country:US
Practice Address - Phone:716-324-5221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician