Individual
LAURENCE CLOUTIER-CHAMPAGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
81 W 115TH ST, NEW YORK, NY 10026-3138
(212) 426-0088
(212) 426-8367
Mailing address
60 MADISON AVE, 5TH, NEW YORK, NY 10010-1600
(212) 545-2400
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
N006470-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00695941
—
NY
Enumeration date
04/16/2012
Last updated
04/15/2014
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