Healthcare Provider Details

I. General information

NPI: 1477884500
Provider Name (Legal Business Name): LAUREL OLGA PAPORTO FMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2010
Last Update Date: 04/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 HAIGHT AVE.
POUGHKEEPSIE NY
12603
US

IV. Provider business mailing address

514 HAIGHT AVE.
POUGHKEEPSIE NY
12603
US

V. Phone/Fax

Practice location:
  • Phone: 845-485-3506
  • Fax: 845-452-7646
Mailing address:
  • Phone: 845-485-3506
  • Fax: 845-452-7646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0810X
TaxonomyChild & Family Psychiatric/Mental Health Clinical Nurse Specialist
License Number400663
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number400663
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: