Healthcare Provider Details

I. General information

NPI: 1013845148
Provider Name (Legal Business Name): MARTHA LAUD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAISIE LAUD MD

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 1ST AVE
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

968 60TH ST APT 317
BROOKLYN NY
11219-4858
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-5506
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number13-3971298
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: