Provider Demographics
NPI:1215299037
Name:LAUDIN, ALAN
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:
Last Name:LAUDIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 IVY LN
Mailing Address - Street 2:
Mailing Address - City:LIDO BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4910
Mailing Address - Country:US
Mailing Address - Phone:516-897-6850
Mailing Address - Fax:
Practice Address - Street 1:91 IVY LN
Practice Address - Street 2:
Practice Address - City:LIDO BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-4910
Practice Address - Country:US
Practice Address - Phone:516-897-6850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist