Provider Demographics
NPI:1295305720
Name:GOLDHAR, LAURA MARIE (PA)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:GOLDHAR
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:38 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MASSENA
Mailing Address - State:NY
Mailing Address - Zip Code:13662-1018
Mailing Address - Country:US
Mailing Address - Phone:315-764-1121
Mailing Address - Fax:855-279-7911
Practice Address - Street 1:38 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MASSENA
Practice Address - State:NY
Practice Address - Zip Code:13662-1018
Practice Address - Country:US
Practice Address - Phone:315-764-1121
Practice Address - Fax:855-279-7911
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant