Provider Demographics
NPI:1780679985
Name:LAOCHUMROONVORAPONG, PAIROTE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:PAIROTE
Middle Name:
Last Name:LAOCHUMROONVORAPONG
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 E 46TH ST
Mailing Address - Street 2:#20M
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-3002
Mailing Address - Country:US
Mailing Address - Phone:212-867-4870
Mailing Address - Fax:
Practice Address - Street 1:1317 3RD AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2995
Practice Address - Country:US
Practice Address - Phone:212-288-2536
Practice Address - Fax:212-288-3206
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214926207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH70037Medicare UPIN
NYA400002376Medicare PIN