Provider Demographics
NPI:1649415076
Name:ROONEY, LAUREN L
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:L
Last Name:ROONEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 JENKINSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-4234
Mailing Address - Country:US
Mailing Address - Phone:845-255-3160
Mailing Address - Fax:
Practice Address - Street 1:45 JENKINSTOWN RD
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-4234
Practice Address - Country:US
Practice Address - Phone:845-255-3160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5847007173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist