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Individual

LAURA RIVERA COUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
243 BOYLE RD, SUITE 1, SELDEN, NY 11784-1929
(631) 696-2000
(631) 696-2003
Mailing address
243 BOYLE RD, SUITE 1, SELDEN, NY 11784-1929
(631) 696-2000
(631) 696-2003

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
284030-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1K3066
HEALTHNET
01
2014484001
KEYSTONE
01
P858418
OXFORD
Enumeration date
10/31/2006
Last updated
03/09/2017
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