Individual
LAURA MACISAAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
350 E 17TH ST, 8TH FLOOR, NEW YORK, NY 10003-3805
(212) 420-2074
Mailing address
PO BOX 95000-2428, PHILADELPHIA, PA 19195-2428
(212) 844-5570
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
207015
NY
Other
Enumeration date
02/07/2007
Last updated
09/25/2012
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