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General NPI Number Information
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NPI Number | 1740274794
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Entity Type | Individual
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Provider Name | LINDA RACHEL LAUGHLIN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/06/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17 E 96TH ST SUITE #1B
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City | NEW YORK
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State | NY
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Zip | 10128-0783
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Country | US
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Telephone | 212-426-6573
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Fax | 212-426-6573
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Provider Business Mailing Address
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Address Line | 152 E 94TH ST APT. #5C
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City | NEW YORK
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State | NY
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Zip | 10128-2510
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Country | US
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Telephone | 212-426-6573
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Fax | 212-426-6573
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 012041
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License Number State | NY
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