Provider Demographics
NPI:1982000246
Name:KRIWOX, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:KRIWOX
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 1:211 WHITE SPRUCE BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1618
Mailing Address - Country:US
Mailing Address - Phone:585-475-8700
Mailing Address - Fax:585-475-9411
Practice Address - Street 1:211 WHITE SPRUCE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1618
Practice Address - Country:US
Practice Address - Phone:585-475-8700
Practice Address - Fax:585-475-9411
Is Sole Proprietor?:No
Enumeration Date:2014-11-14
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306902207RH0003X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology