Provider Demographics
NPI:1942651740
Name:LAUVAS, KRISTINA
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:LAUVAS
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 1:118 PLEASANT LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT UPTON
Mailing Address - State:NY
Mailing Address - Zip Code:13809-4199
Mailing Address - Country:US
Mailing Address - Phone:607-287-6025
Mailing Address - Fax:
Practice Address - Street 1:105 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-6175
Practice Address - Country:US
Practice Address - Phone:607-286-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007835225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant