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General NPI Number Information
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NPI Number | 1538568795
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Entity Type | Individual
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Provider Name | LAURA CATHERINE UNDERWOOD NP
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Gender | Female
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Dates
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Enumeration Date | 08/13/2014
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 530 1ST AVE 10S
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City | NEW YORK
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State | NY
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Zip | 10016-6402
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Country | US
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Telephone | 813-956-4232
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Fax |
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Provider Business Mailing Address
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Address Line | 46 WHITNEY PL APT 3
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City | BUFFALO
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State | NY
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Zip | 14201-3302
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Country | US
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Telephone | 718-801-3135
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 306143
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 594047
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License Number State | NY
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