Provider Demographics
NPI:1427238302
Name:LAME, ALBANA VEDAT
Entity type:Individual
Prefix:
First Name:ALBANA
Middle Name:VEDAT
Last Name:LAME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALBANA
Other - Middle Name:VEDAT
Other - Last Name:KULLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33 POLK AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-4220
Mailing Address - Country:US
Mailing Address - Phone:203-753-7914
Mailing Address - Fax:
Practice Address - Street 1:80 PHOENIX AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1418
Practice Address - Country:US
Practice Address - Phone:203-756-8021
Practice Address - Fax:203-596-9038
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006457124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist