MEDICARE: DR. BRETT LAURING M.D.

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	207ZP0101X	Anatomic Pathology Physician	207558	NY

General Provider Information

NPI Number	:	1841302817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRETT LAURING M.D.

Provider Business Mailing Address
First Line	:	650 W 168TH ST
Second Line	:	BB-1427 DEPT PATHOLOGY COLUMBIA UNIVERSITY
City	:	NEW YORK
State	:	NY
Zip	:	10032-3702
Country	:	US
Telephone Number	:	212-305-0395
Fax Number	:	212-305-5498

Provider Business Practice Location Address
First Line	:	650 W 168TH ST
Second Line	:	BB-1427 DEPT PATHOLOGY COLUMBIA UNIVERSITY
City	:	NEW YORK
State	:	NY
Zip	:	10032-3702
Country	:	US
Telephone Number	:	212-305-0395
Fax Number	:	212-305-5498

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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