Provider Demographics
NPI:1821388489
Name:SCUTARI, LAURA (RN)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:SCUTARI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MERRILL AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3312
Mailing Address - Country:US
Mailing Address - Phone:718-370-7529
Mailing Address - Fax:718-370-7551
Practice Address - Street 1:40 MERRILL AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3312
Practice Address - Country:US
Practice Address - Phone:718-370-7529
Practice Address - Fax:718-370-7551
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335911-1163W00000X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163W00000XNursing Service ProvidersRegistered Nurse