Provider Demographics
NPI:1346226073
Name:NASH, LAURIE C (MD)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:C
Last Name:NASH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3275
Mailing Address - Country:US
Mailing Address - Phone:212-486-5380
Mailing Address - Fax:888-434-9303
Practice Address - Street 1:799 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3275
Practice Address - Country:US
Practice Address - Phone:212-486-5380
Practice Address - Fax:888-434-9303
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189601207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY186611Medicare ID - Type Unspecified
NYG04341Medicare UPIN