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General NPI Number Information
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NPI Number | 1275054785
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Entity Type | Individual
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Provider Name | DR. LAURENT GANRY
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Gender | Male
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 27005 76TH AVE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1402
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Country | US
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Telephone | 646-269-8637
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Fax |
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Provider Business Mailing Address
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Address Line | 341 SIXTH AVE
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City | PELHAM
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State | NY
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Zip | 10803-1201
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Country | US
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Telephone | 646-269-8637
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 329411
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 329411
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | 329411
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 329411
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License Number State | NY
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