=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285263061
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LARYSSA DO OURO-RODRIGUES MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2020
-----------------------------------------------------
Last Update Date | 11/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 36 W 44TH ST STE 600B
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10036-8112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-299-8256
-----------------------------------------------------
Fax | 646-661-3963
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 685 1ST AVE APT 31E
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-2362
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-526-4828
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | 336585
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208VP0000X
-----------------------------------------------------
Taxonomy Name | Pain Medicine Physician
-----------------------------------------------------
License Number | 336585
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------