Provider Demographics
NPI:1518354299
Name:CHOLEVA, LAURYN (MD)
Entity Type:Individual
Prefix:
First Name:LAURYN
Middle Name:
Last Name:CHOLEVA
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 1:1468 MADISON AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6508
Mailing Address - Country:US
Mailing Address - Phone:212-241-6936
Mailing Address - Fax:
Practice Address - Street 1:1468 MADISON AVE FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6508
Practice Address - Country:US
Practice Address - Phone:212-241-6936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2021-12-29
Deactivation Date:2015-11-24
Deactivation Code:
Reactivation Date:2015-12-02
Provider Licenses
StateLicense IDTaxonomies
NY2935482080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology