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Individual

LAURA LOUISE FORD-MUKKAMALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
5959 BIG TREE RD, ORCHARD PARK, NY 14127-2291
(716) 710-8266
(716) 710-8267
Mailing address
908 NIAGARA FALLS BLVD STE 208, NORTH TONAWANDA, NY 14120-2019
(716) 692-3302
(716) 692-4342

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
265258
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03489461
NY
Enumeration date
08/18/2006
Last updated
11/08/2017
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