Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 265351 | NY |
NPI | 1275728818 |
---|---|
Provider Name | Laura Czulada |
First Address | Huntington, NY 11743-3425 |
Second Address | Stony Brook, NY 11794-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2007 |
Last Update Date | 22/04/2015 |