Healthcare Provider Details

I. General information

NPI: 1164879599
Provider Name (Legal Business Name): JULIEN DAVID LAOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2016
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 E 26TH ST
NEW YORK NY
10016-9161
US

IV. Provider business mailing address

1000 10TH AVE
NEW YORK NY
10019-1147
US

V. Phone/Fax

Practice location:
  • Phone: 718-557-8751
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number302560-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number302560-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: