Provider Demographics
NPI:1972134443
Name:ABBRUZZESE, LAUREL DANIELS (PT)
Entity Type:Individual
Prefix:DR
First Name:LAUREL
Middle Name:DANIELS
Last Name:ABBRUZZESE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 W 168TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3925
Mailing Address - Country:US
Mailing Address - Phone:212-305-3916
Mailing Address - Fax:
Practice Address - Street 1:617 W 168TH ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3925
Practice Address - Country:US
Practice Address - Phone:212-305-3916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014918208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation