Healthcare Provider Details

I. General information

NPI: 1285827865
Provider Name (Legal Business Name): LAURA ELIZABETH PUNZONE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2007
Last Update Date: 01/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E 57TH ST STE 1420
NEW YORK NY
10022-2108
US

IV. Provider business mailing address

115 E 57TH ST STE 1420
NEW YORK NY
10022-2108
US

V. Phone/Fax

Practice location:
  • Phone: 212-838-8023
  • Fax: 212-838-8027
Mailing address:
  • Phone: 212-838-8023
  • Fax: 212-838-8027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number029591
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: