Healthcare Provider Details

I. General information

NPI: 1295003630
Provider Name (Legal Business Name): LAURA ANN LAROCHE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2011
Last Update Date: 12/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1247 LAKES RD
MONROE NY
10950-4221
US

IV. Provider business mailing address

1247 LAKES RD
MONROE NY
10950-4221
US

V. Phone/Fax

Practice location:
  • Phone: 845-782-8678
  • Fax: 845-782-2004
Mailing address:
  • Phone: 845-782-8678
  • Fax: 845-782-2004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number329320-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: