Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 30430 | NE |
N | 208D00000X | General Practice Physician | 30430 | NE |
NPI | 1023478344 |
---|---|
Provider Name | Dr. Laura Nicole Becker |
First Address | West Point, NY 10996-1109 |
Second Address | West Point, NY 10996-1109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/02/2016 |
Last Update Date | 13/07/2020 |