# CCMMA TX PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841829819
- **Authorized official:** LAURIE LADUCA (MANAGER)
- **Authorized official phone:** (845) 702-2711

## Contact information

- **Practice address:** 2 PARK AVE STE 2039, NEW YORK, NY 10016-5675
- **Practice address phone:** (845) 702-2711
- **Mailing address:** PO BOX 631801, CINCINNATI, OH 45263-1801
- **Mailing address phone:** (845) 702-2711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 207LC0200X | Critical Care Medicine (Anesthesiology) Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 2084A2900X | Neurocritical Care Physician | — | NULL | — |
| 2084A2900X | Neurocritical Care Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 04/02/2020
- **Last updated:** 04/15/2026