Provider Demographics
NPI:1689820516
Name:DOMBROWSKI, LAURA L (DO)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:L
Last Name:DOMBROWSKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 FOX MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-2867
Mailing Address - Country:US
Mailing Address - Phone:716-662-3650
Mailing Address - Fax:
Practice Address - Street 1:2121 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2693
Practice Address - Country:US
Practice Address - Phone:716-836-7506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0560157575207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology