Provider Demographics
NPI:1043210289
Name:LAFLEUR, CARA S
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:S
Last Name:LAFLEUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 SAW MILL RIVER RD
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1533
Mailing Address - Country:US
Mailing Address - Phone:914-593-1606
Mailing Address - Fax:914-593-1790
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:SUITE 200N
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-493-7701
Practice Address - Fax:914-345-0653
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002947133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY09Q932L141Medicare PIN
NY09Q931Medicare PIN