MEDICARE: MS. LAURA DORN APRN- FNP

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	207Q00000X	Family Medicine Physician	F352058-01	NY

General Provider Information

NPI Number	:	1891479184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA DORN APRN- FNP

Provider Business Mailing Address
First Line	:	7 LOUIS AVE
Second Line	:
City	:	VALLEY COTTAGE
State	:	NY
Zip	:	10989-2327
Country	:	US
Telephone Number	:	914-629-6773
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 LOUIS AVE
Second Line	:
City	:	VALLEY COTTAGE
State	:	NY
Zip	:	10989-2327
Country	:	US
Telephone Number	:	914-629-6773
Fax Number	:

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

Provider Enumeration Date	:	06/15/2023
Last Update Date	:	06/15/2023

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