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Individual

EMMA LAURETA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3415 BAINBRIDGE AVENUE AT GUNHILL ROAD, BRONX, NY 10467
(718) 920-4378
Mailing address
6751 182ND ST, FRESH MEADOWS, NY 11365-3505
(718) 969-3001

Taxonomy

Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
246578
NY
2084N0600X
Clinical Neurophysiology Physician
246578
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02118376
NY
Enumeration date
09/26/2006
Last updated
03/10/2008
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