Healthcare Provider Details

I. General information

NPI: 1760393540
Provider Name (Legal Business Name): MS. LAURA P LEROY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 CLARKSON AVE APT 202
BROOKLYN NY
11226-8506
US

IV. Provider business mailing address

270 CLARKSON AVE APT 202
BROOKLYN NY
11226-8506
US

V. Phone/Fax

Practice location:
  • Phone: 347-488-2837
  • Fax:
Mailing address:
  • Phone: 347-488-2837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1229797
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: