Provider Demographics
NPI:1861706368
Name:LAURINO, KRISTIN MEREDITH (DPT)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:MEREDITH
Last Name:LAURINO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:MEREDITH
Other - Last Name:OLSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1420 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-4411
Mailing Address - Country:US
Mailing Address - Phone:516-353-6114
Mailing Address - Fax:
Practice Address - Street 1:1420 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-4411
Practice Address - Country:US
Practice Address - Phone:516-353-6114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032822225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist