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Individual

LAURI MIKRUT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
88 SLATE CREEK DR, 12, BUFFALO, NY 14227-2862
(716) 473-2697
Mailing address
88 SLATE CREEK DR, 12, BUFFALO, NY 14227-2862

Taxonomy

Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
631262
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
631262
NYS
NY
Enumeration date
03/23/2017
Last updated
03/23/2017
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