Individual
ELLEN PETERSON LAURIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
462 1ST AVE, NEW YORK, NY 10016-9196
(212) 265-5062
Mailing address
47 HERITAGE CT, HILLSDALE, NJ 07642-1226
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F381659
NY
Other
Enumeration date
12/18/2006
Last updated
07/08/2007
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