Provider Demographics
NPI:1114085263
Name:JOSEPHS, LAURA (PHD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:JOSEPHS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 EAST 68TH STREET
Mailing Address - Street 2:SUITE 1H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-6024
Mailing Address - Country:US
Mailing Address - Phone:212-249-5244
Mailing Address - Fax:212-746-4554
Practice Address - Street 1:210 EAST 68TH STREET
Practice Address - Street 2:SUITE 1H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-6024
Practice Address - Country:US
Practice Address - Phone:212-249-5244
Practice Address - Fax:212-746-4554
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7778103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
R52955Medicare UPIN
NYV23121Medicare ID - Type Unspecified