Individual
COLLEEN LAICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
396 BROADWAY, KINGSTON, NY 12401-4626
(845) 331-3131
Mailing address
1 S WASHINGTON AVE, KINGSTON, NY 12401-6217
(201) 889-6814
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
349423
NY
363LF0000X
Family Nurse Practitioner
349423
NY
Other
Enumeration date
04/04/2022
Last updated
05/14/2024
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