Provider Demographics
NPI:1144400466
Name:KAZOKAS, LAURA H (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:H
Last Name:KAZOKAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16355 25TH DR
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-1005
Mailing Address - Country:US
Mailing Address - Phone:718-461-0716
Mailing Address - Fax:
Practice Address - Street 1:273 PINE HOLLOW RD
Practice Address - Street 2:
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771-4707
Practice Address - Country:US
Practice Address - Phone:516-624-7050
Practice Address - Fax:516-624-7057
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050777183500000X
NJ28RI03051900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01660113Medicaid