Provider Demographics
NPI:1326438243
Name:MAGRI, LAURA (RPA-C)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:MAGRI
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:FRIED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPA-C
Mailing Address - Street 1:601 FRANKLIN AVENUE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530
Mailing Address - Country:US
Mailing Address - Phone:516-742-3200
Mailing Address - Fax:516-746-5847
Practice Address - Street 1:601 FRANKLIN AVENUE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-742-3200
Practice Address - Fax:516-746-5847
Is Sole Proprietor?:No
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004537-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant