Healthcare Provider Details

I. General information

NPI: 1831468602
Provider Name (Legal Business Name): LAURA DEL VECCHIO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2011
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 YORK AVE FL 4
NEW YORK NY
10021-5663
US

IV. Provider business mailing address

10 BARCLAY ST APT 19B
NEW YORK NY
10007-2712
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-2111
  • Fax: 646-962-0159
Mailing address:
  • Phone: 305-321-4844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9280230
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF347322-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: