Provider Demographics
NPI:1881995348
Name:NEWBOLD, LAURA CRISTINA (LMSW)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:CRISTINA
Last Name:NEWBOLD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:CRISTINA
Other - Last Name:HARRIOTT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:130 W KINGSBRIDGE RD
Mailing Address - Street 2:BRONX VA HOSPITAL
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-3904
Mailing Address - Country:US
Mailing Address - Phone:718-584-9000
Mailing Address - Fax:
Practice Address - Street 1:130 W KINGSBRIDGE RD
Practice Address - Street 2:BRONX VA HOSPITAL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-3904
Practice Address - Country:US
Practice Address - Phone:718-584-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080191104100000X
NY695363163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No163W00000XNursing Service ProvidersRegistered Nurse