MEDICARE: YVESON LAURORE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WI0500X	Infusion Therapy Registered Nurse	617116-01	NY
2	163WM0705X	Medical-Surgical Registered Nurse	617116-01	NY
3	171W00000X	Contractor	617116-01	NY
4	163W00000X	Registered Nurse	617116-01	NY

General Provider Information

NPI Number	:	1437921905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVESON LAURORE

Provider Business Mailing Address
First Line	:	790 BELLMORE RD
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-3727
Country	:	US
Telephone Number	:	516-993-1267
Fax Number	:

Provider Business Practice Location Address
First Line	:	790 BELLMORE RD
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-3727
Country	:	US
Telephone Number	:	516-993-1267
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2023
Last Update Date	:	10/26/2023

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Directions to “ YVESON LAURORE ” Practice Location

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