Provider Demographics
NPI:1588619753
Name:LAURO, ANTHONY (CH)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:LAURO
Suffix:
Gender:M
Credentials:CH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 RAMAPO RD
Mailing Address - Street 2:STE 2
Mailing Address - City:GARNERVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10923-1714
Mailing Address - Country:US
Mailing Address - Phone:845-786-2212
Mailing Address - Fax:845-786-2224
Practice Address - Street 1:91 RAMAPO RD
Practice Address - Street 2:STE 2
Practice Address - City:GARNERVILLE
Practice Address - State:NY
Practice Address - Zip Code:10923-1714
Practice Address - Country:US
Practice Address - Phone:845-786-2212
Practice Address - Fax:845-786-2224
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006078111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
133443281OtherTAX IDENTIFICATION NUMBER
NYC06078-2OtherWORKMANS COMPENSATION ID
NYC06078-2OtherWORKMANS COMPENSATION ID