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Individual

MR. LAURENCE GUPITEO

Active
Sole proprietor
No

Provider details

NPI number
Gender
X
Credential
AGPCNP-C

Contact information

Practice address
1111 TARGEE ST, STATEN ISLAND, NY 10304-4323
(347) 834-5814
Mailing address
1111 TARGEE ST, STATEN ISLAND, NY 10304-4323

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
26NJ15338300
NJ
363LA2200X
Adult Health Nurse Practitioner
Primary
312285
NY

Other

Enumeration date
06/30/2025
Last updated
06/30/2025
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