Healthcare Provider Details

I. General information

NPI: 1952002644
Provider Name (Legal Business Name): JAMIE LAUER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2023
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 223RD ST
OAKLAND GDNS NY
11364-1936
US

IV. Provider business mailing address

5700 223RD ST
OAKLAND GARDENS NY
11364-1936
US

V. Phone/Fax

Practice location:
  • Phone: 718-279-6500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number115124
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: