Provider Demographics
NPI:1083702278
Name:MIESZERSKI, LAURA ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELIZABETH
Last Name:MIESZERSKI
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1037 MAIN ST
Mailing Address - Street 2:HUDSON RIVER HEALTHCARE INC
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2913
Mailing Address - Country:US
Mailing Address - Phone:845-838-7020
Mailing Address - Fax:845-838-6105
Practice Address - Street 1:1037 MAIN ST
Practice Address - Street 2:HUDSON RIVER HEALTHCARE INC
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-2913
Practice Address - Country:US
Practice Address - Phone:845-831-0400
Practice Address - Fax:845-831-0793
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2014-01-13
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY209259207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEN861OtherMEDICARE GROUP ID
NY02055250Medicaid
NY02055250Medicaid
NY64N151Medicare PIN