Healthcare Provider Details

I. General information

NPI: 1891480042
Provider Name (Legal Business Name): LAURIN LARIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 EAST 124TH STREET
NEW YORK NY
10035
US

IV. Provider business mailing address

54 EAST 124TH STREET
NEW YORK NY
10035
US

V. Phone/Fax

Practice location:
  • Phone: 212-410-8143
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number007535
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: