Provider Demographics
NPI:1962232892
Name:PAYANO-DAM, LUCRECIA
Entity type:Individual
Prefix:
First Name:LUCRECIA
Middle Name:
Last Name:PAYANO-DAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 KENT RD
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-3846
Mailing Address - Country:US
Mailing Address - Phone:646-981-5608
Mailing Address - Fax:
Practice Address - Street 1:19 KENT RD
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-3846
Practice Address - Country:US
Practice Address - Phone:646-981-5608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist