Provider Demographics
NPI:1922145010
Name:MONSERRAT, LAURA (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:MONSERRAT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 E 86TH ST
Mailing Address - Street 2:APT 18E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7504
Mailing Address - Country:US
Mailing Address - Phone:212-628-7692
Mailing Address - Fax:212-879-5238
Practice Address - Street 1:510 E 86TH ST
Practice Address - Street 2:APT 18E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-7504
Practice Address - Country:US
Practice Address - Phone:212-628-7692
Practice Address - Fax:212-879-5238
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010680-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV8C241Medicare ID - Type UnspecifiedPROVIDER ID