Healthcare Provider Details

I. General information

NPI: 1376289157
Provider Name (Legal Business Name): DANIEL LAOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2022
Last Update Date: 10/07/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PARK AVE FL 8
NEW YORK NY
10016-5802
US

IV. Provider business mailing address

1 PARK AVE
NEW YORK NY
10016-5802
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-7419
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number324472
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: