Provider Demographics
NPI:1063482990
Name:COZZARELLI, LAURA E (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:E
Last Name:COZZARELLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:155 E 72ND ST
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4371
Mailing Address - Country:US
Mailing Address - Phone:212-583-2866
Mailing Address - Fax:212-737-9361
Practice Address - Street 1:155 E 72ND ST
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4371
Practice Address - Country:US
Practice Address - Phone:212-583-2866
Practice Address - Fax:212-737-9361
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY206485-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01975108Medicaid
NY206485-1OtherLICENSE
NY206485-1OtherLICENSE
NY01975108Medicaid
NY41Z591Medicare PIN
NY41Z591Medicare ID - Type Unspecified