Basic Information
| Provider Information | |||||||||
| NPI: | 1710321872 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PFISTER | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | ANN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12212 85TH AVE | ||||||||
| Address2: | FL 1 | ||||||||
| City: | KEW GARDENS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114153318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184595592 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12212 85TH AVE | ||||||||
| Address2: | FL 1 | ||||||||
| City: | KEW GARDENS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114153318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184595592 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2013 | ||||||||
| LastUpdateDate: | 04/19/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 662171-1 | NY | Y | Nursing Service Providers | Registered Nurse |
No ID Information.