Healthcare Provider Details

I. General information

NPI: 1437528775
Provider Name (Legal Business Name): LAURA KOVACS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2015
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 WEST ROAD THE JOSEPH D'AQUANNI WEST ROAD INTERMEDIATE SCHOOL
PLEASANT VALLEY NY
12569-6221
US

IV. Provider business mailing address

181 WEST ROAD THE JOSEPH D'AQUANNI WEST ROAD INTERMEDIATE SCHOOL
PLEASANT VALLEY NY
12569-6221
US

V. Phone/Fax

Practice location:
  • Phone: 845-635-4310
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number477225
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: