Lalley-Demong, Vanessa

Lalley-Demong, Vanessa is an individual health care provider with primary practice located at 4000 Medical Center Dr Suite 104, Fayetteville NY 13066-6635. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Lalley-Demong, Vanessa can be contacted via phone (315) 663-0059.

Contact Information

Primary practice address
4000 Medical Center Dr Suite 104 Fayetteville NY 13066-6635
Phone: (315) 663-0059
Fax: (315) 663-0123
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 275026 New York

Profile Details

NPI number 1841511342
LBN Legal business name Lalley-Demong, Vanessa
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2010
Last updated May 19th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841511342 NPPES
New York MEDICAID 03950429

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