Provider Demographics
NPI:1003888314
Name:LAURIA, GERALD A (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:A
Last Name:LAURIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 BIG TREE RD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-4116
Mailing Address - Country:US
Mailing Address - Phone:716-662-7337
Mailing Address - Fax:716-662-0641
Practice Address - Street 1:5800 BIG TREE RD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-4116
Practice Address - Country:US
Practice Address - Phone:716-662-7337
Practice Address - Fax:716-662-0641
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158232208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1200857OtherINDEPENDENT HEALTH
NY00844679Medicaid
NY00010312201OtherUNIVERA HEALTHCARE
NY000500390001OtherBLUE CROSS BLUE SHIELD