MEDICARE: LAURA FLOOD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WL0100X	Lactation Consultant (Registered Nurse)	L-153099	NY

General Provider Information

NPI Number	:	1184183402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA FLOOD

Provider Business Mailing Address
First Line	:	59 ATLANTIC AVE APT 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-6746
Country	:	US
Telephone Number	:	917-432-9624
Fax Number	:

Provider Business Practice Location Address
First Line	:	59 ATLANTIC AVE APT 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-6746
Country	:	US
Telephone Number	:	917-432-9624
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2019
Last Update Date	:	03/16/2019

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Directions to “ LAURA FLOOD ” Practice Location

Language	Start Address	Practice Location

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