MEDICARE: LAURIE MORAN-MARSH NP-P

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	101YM0800X	Mental Health Counselor	345572-1	NY

General Provider Information

NPI Number	:	1396912291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE MORAN-MARSH NP-P

Provider Business Mailing Address
First Line	:	11 MARSHALL RD STE 2L
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-4134
Country	:	US
Telephone Number	:	845-298-4350
Fax Number	:	845-298-4354

Provider Business Practice Location Address
First Line	:	11 MARSHALL RD STE 2L
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-4134
Country	:	US
Telephone Number	:	845-298-4350
Fax Number	:	845-298-4354

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

Provider Enumeration Date	:	05/12/2008
Last Update Date	:	05/12/2008

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