Healthcare Provider Details

I. General information

NPI: 1598841371
Provider Name (Legal Business Name): ULLA KRISTIINA LAAKSO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 PARK AVE
NEW YORK NY
10021-0255
US

IV. Provider business mailing address

910 PARK AVE
NEW YORK NY
10021-0255
US

V. Phone/Fax

Practice location:
  • Phone: 212-517-3900
  • Fax: 212-452-1336
Mailing address:
  • Phone: 212-517-3900
  • Fax: 212-452-1336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number174920
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: