Organization
CCMMA TX PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE LADUCA (MANAGER)
(845) 702-2711
Entity
Organization
Contact information
Practice address
2 PARK AVE STE 2039, NEW YORK, NY 10016-5675
(845) 702-2711
Mailing address
PO BOX 631801, CINCINNATI, OH 45263-1801
(845) 702-2711
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
2084A2900X
Neurocritical Care Physician
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
04/02/2020
Last updated
04/15/2026
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