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General NPI Number Information
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NPI Number | 1790198638
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Entity Type | Organization
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Legal Business Name | NEW YORK UNIVERSITY LANGONE MEDICAL CENTER
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Dates
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Enumeration Date | 06/09/2014
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Last Update Date | 06/09/2014
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Provider Practice Location Address
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Address Line | 530 1ST AVE SUITE 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 | 212-263-3166
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Fax |
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Provider Business Mailing Address
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Address Line | 60 MONITOR ST #3C
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City | BROOKLYN
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State | NY
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Zip | 11222-5252
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Country | US
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Telephone | 813-956-4232
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | LAURA CATHERINE UNDERWOOD
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Credential | NP
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Telephone | 813-956-4232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 306143
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License Number State | NY
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