Provider Demographics
NPI:1134128945
Name:MECHANIC, LAURA J (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:J
Last Name:MECHANIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:210 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2901
Mailing Address - Country:US
Mailing Address - Phone:914-831-6850
Mailing Address - Fax:914-681-5264
Practice Address - Street 1:210 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-2901
Practice Address - Country:US
Practice Address - Phone:914-831-6850
Practice Address - Fax:917-681-5264
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183988207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01497218Medicaid
NY47K191Medicare PIN
NY01497218Medicaid