Provider Demographics
NPI:1548760903
Name:MACCARALD, LAURA MARGARET (CNM)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MARGARET
Last Name:MACCARALD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 WILLIAMEE RD
Mailing Address - Street 2:
Mailing Address - City:TRUMANSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14886-9617
Mailing Address - Country:US
Mailing Address - Phone:607-229-5790
Mailing Address - Fax:
Practice Address - Street 1:20 ARROWOOD DR
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1869
Practice Address - Country:US
Practice Address - Phone:607-266-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF001853176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife