Provider Demographics
NPI:1245880244
Name:RECODER, LAURE E
Entity type:Individual
Prefix:
First Name:LAURE
Middle Name:E
Last Name:RECODER
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 1:1735 YORK AVE APT 16A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6858
Mailing Address - Country:US
Mailing Address - Phone:203-832-0874
Mailing Address - Fax:
Practice Address - Street 1:1735 YORK AVE APT 16A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6858
Practice Address - Country:US
Practice Address - Phone:203-832-0874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency