Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 206159 | NY |
Y | 2084N0400X | Neurologist | 206159 | NY |
N | 2084N0600X | Clinical Neurophysiologist | 206159 | NY |
N | 2084V0102X | Vascular Neurology | 206159 | NY |
NPI | 1588642243 |
---|---|
Provider Name | Dr. Laura Gray Schoenberg |
First Address | New Hyde Park, NY 11040-4720 |
Second Address | New Hyde Park, NY 11040-4720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2006 |
Last Update Date | 04/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01906770 | (05) | NY |
130020669 | RAILROAD MEDICARE (01) | NY |
7676026 | AETNA (01) | NY |
G66350 | (02) | NY |
P919453 | OXFORD (01) |