Provider Demographics
NPI:1457580268
Name:GRAS, LAURA Z (PT DSC, GCS)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:Z
Last Name:GRAS
Suffix:
Gender:F
Credentials:PT DSC, GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 LYNN RD
Mailing Address - Street 2:
Mailing Address - City:AVERILL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12018-2700
Mailing Address - Country:US
Mailing Address - Phone:518-244-2066
Mailing Address - Fax:
Practice Address - Street 1:4164 NY 2
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-9029
Practice Address - Country:US
Practice Address - Phone:518-326-9272
Practice Address - Fax:518-326-9273
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0124451225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist