Provider Demographics
NPI:1750658365
Name:STEIN, LAURA GEORGINA
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:GEORGINA
Last Name:STEIN
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:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10919-0043
Mailing Address - Country:US
Mailing Address - Phone:845-744-2031
Mailing Address - Fax:845-744-4075
Practice Address - Street 1:4000 ROUTE 302
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:NY
Practice Address - Zip Code:10919
Practice Address - Country:US
Practice Address - Phone:845-744-2031
Practice Address - Fax:845-744-4075
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY436544163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse