Provider Demographics
NPI:1376791228
Name:MASCIARELLI, LAURA (MS, PT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MASCIARELLI
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2415 JERUSALEM AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-1870
Mailing Address - Country:US
Mailing Address - Phone:516-785-5257
Mailing Address - Fax:516-785-5154
Practice Address - Street 1:2415 JERUSALEM AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1870
Practice Address - Country:US
Practice Address - Phone:516-785-5257
Practice Address - Fax:516-785-5154
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY021009-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics