Provider Demographics
NPI:1184183402
Name:FLOOD, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:FLOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TESSI
Other - Middle Name:
Other - Last Name:FLOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:59 ATLANTIC AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-6746
Mailing Address - Country:US
Mailing Address - Phone:917-432-9624
Mailing Address - Fax:
Practice Address - Street 1:59 ATLANTIC AVE APT 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-6746
Practice Address - Country:US
Practice Address - Phone:917-432-9624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-16
Last Update Date:2019-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYL-153099163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant