Provider Demographics
NPI:1861477945
Name:LAURIE C NASH MD PLLC
Entity Type:Organization
Organization Name:LAURIE C NASH MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-486-5380
Mailing Address - Street 1:654 MADISON AVE
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-8404
Mailing Address - Country:US
Mailing Address - Phone:212-486-5380
Mailing Address - Fax:
Practice Address - Street 1:654 MADISON AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-8404
Practice Address - Country:US
Practice Address - Phone:212-486-5380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189601173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWCW981Medicare ID - Type Unspecified