Provider Demographics
NPI:1295956506
Name:LAORNO, CAROLYN (PA)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:LAORNO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WESTAGE BUSINESS CTR DR STE 231
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-2268
Mailing Address - Country:US
Mailing Address - Phone:845-896-6666
Mailing Address - Fax:845-896-2854
Practice Address - Street 1:200 WESTAGE BUSINESS CTR DR STE 231
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2268
Practice Address - Country:US
Practice Address - Phone:845-896-6669
Practice Address - Fax:845-896-2854
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY17024401174400000X
NY008585174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
A400016698Medicare PIN