Provider Demographics
NPI:1356602767
Name:DAVIDS, LAURA MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MICHELLE
Last Name:DAVIDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:BARONOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:150 VETS HWY UNIT 141
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-6408
Mailing Address - Country:US
Mailing Address - Phone:516-225-4990
Mailing Address - Fax:
Practice Address - Street 1:750 HAWKINS AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-2230
Practice Address - Country:US
Practice Address - Phone:631-737-0055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280189208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation