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General NPI Number Information
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NPI Number | 1669630026
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Entity Type | Individual
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Provider Name | LAURA KHANALI CHESONI M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/01/2008
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Last Update Date | 08/01/2011
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Provider Practice Location Address
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Address Line | 121 DEKALB AVE
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City | BROOKLYN
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State | NY
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Zip | 11201-5425
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Country | US
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Telephone | 718-250-8536
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Fax |
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Provider Business Mailing Address
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Address Line | 68 S SERVICE RD SUITE 350
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City | MELVILLE
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State | NY
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Zip | 11747-2358
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Country | US
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Telephone | 516-945-3000
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Fax | 516-945-3131
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 262403
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | AF24356090F8
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License Number State | DC
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