Healthcare Provider Details

I. General information

NPI: 1134128945
Provider Name (Legal Business Name): LAURA J MECHANIC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 10/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 WESTCHESTER AVE
WHITE PLAINS NY
10604-2901
US

IV. Provider business mailing address

210 WESTCHESTER AVE
WHITE PLAINS NY
10604-2901
US

V. Phone/Fax

Practice location:
  • Phone: 914-831-6850
  • Fax: 917-681-5264
Mailing address:
  • Phone: 914-831-6850
  • Fax: 914-681-5264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number183988
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: