Provider Demographics
NPI:1063117315
Name:LAURA AMRAM PSYCHIATRY PC
Entity type:Organization
Organization Name:LAURA AMRAM PSYCHIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMRAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-539-3646
Mailing Address - Street 1:PO BOX 520390
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11352-0390
Mailing Address - Country:US
Mailing Address - Phone:718-755-0656
Mailing Address - Fax:888-500-0406
Practice Address - Street 1:95-20 63 ROAD
Practice Address - Street 2:SUITE O
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-755-0656
Practice Address - Fax:888-500-0406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty