Individual
LAURIE ANN GROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
27005 76TH AVE DEPT OF, NEW HYDE PARK, NY 11040-1402
(718) 470-7390
Mailing address
68 S SERVICE RD STE 350, MELVILLE, NY 11747-2358
(516) 945-3000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
22 620727
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
620727
NY
Other
Enumeration date
11/25/2009
Last updated
09/25/2019
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