Provider Demographics
NPI:1710970280
Name:LAUDONE, VINCENT P (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:P
Last Name:LAUDONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1275 YORK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6007
Mailing Address - Country:US
Mailing Address - Phone:646-422-4306
Mailing Address - Fax:212-452-3323
Practice Address - Street 1:1275 YORK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6007
Practice Address - Country:US
Practice Address - Phone:646-422-4306
Practice Address - Fax:212-452-3323
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT028815208800000X
NY249315208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0S0308OtherHEALTH NET
CT001288150Medicaid
CT06-1406459OtherMULTIPLAN
CT06-1406459OtherUNITED HEALTHCARE
CT010028815CT01OtherANTHEM BCBS
CT06-1406459OtherCOLONIAL COOPERATIVE CARE
MA3164861Medicaid
CT06-1406459OtherFOCUS
CT06-1406459OtherGREAT WEST
CT06-1406459OtherHMC, PPO
CT13805OtherHEALTH NEW ENGLAND
CT2055861OtherAETNA
CTP888928OtherOXFORD
CT0203119OtherCIGNA
CT028815OtherCONNECTICARE
CT06-1406459OtherCORVEL
CT06-1406459OtherNORTHEAST HEALTH DIRECT
CT06-1406459OtherPRIVATE HEALTHCARE SYSTEM
CTP888928OtherOXFORD
CT340000283Medicare ID - Type Unspecified