Healthcare Provider Details

I. General information

NPI: 1508077512
Provider Name (Legal Business Name): LAURA WHITMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 W 72ND ST 3A
NEW YORK NY
10023-2675
US

IV. Provider business mailing address

255 W END AVE 3A
NEW YORK NY
10023-3605
US

V. Phone/Fax

Practice location:
  • Phone: 212-721-8740
  • Fax:
Mailing address:
  • Phone: 212-875-0302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0005X
TaxonomyNeurodevelopmental Disabilities Physician
License Number177971
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number177971
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number177971
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: