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General NPI Number Information
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NPI Number | 1215436886
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Entity Type | Individual
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Provider Name | LAURA ROSE CHASE PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/08/2018
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 3601 HEMPSTEAD TPKE STE 405
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City | LEVITTOWN
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State | NY
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Zip | 11756-1331
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Country | US
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Telephone | 631-714-4100
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Fax | 631-714-4191
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Provider Business Mailing Address
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Address Line | 24 GROVE ST
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City | MASSAPEQUA
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State | NY
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Zip | 11758-5101
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Country | US
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Telephone | 631-714-4100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 406353
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 342818
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License Number State | NY
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