MEDICARE: ANTHONY LAURO CH

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	111N00000X	Chiropractor	X006078	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	133443281	OTHER		TAX IDENTIFICATION NUMBER
2	C06078-2	OTHER	NY	WORKMANS COMPENSATION ID

General Provider Information

NPI Number	:	1588619753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY LAURO CH

Provider Business Mailing Address
First Line	:	91 RAMAPO RD
Second Line	:	STE 2
City	:	GARNERVILLE
State	:	NY
Zip	:	10923-1714
Country	:	US
Telephone Number	:	845-786-2212
Fax Number	:	845-786-2224

Provider Business Practice Location Address
First Line	:	91 RAMAPO RD
Second Line	:	STE 2
City	:	GARNERVILLE
State	:	NY
Zip	:	10923-1714
Country	:	US
Telephone Number	:	845-786-2212
Fax Number	:	845-786-2224

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	04/25/2013

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Directions to “ ANTHONY LAURO CH” Practice Location

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