Basic Information
| Provider Information | |||||||||
| NPI: | 1811190705 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUDERIAN | ||||||||
| FirstName: | LAURA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 35 E 21ST ST | ||||||||
| Address2: | 7TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100106212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125300659 | ||||||||
| FaxNumber: | 2128674353 | ||||||||
| Practice Location | |||||||||
| Address1: | 35 E 21ST ST | ||||||||
| Address2: | 7TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100106212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125300659 | ||||||||
| FaxNumber: | 2128674353 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2007 | ||||||||
| LastUpdateDate: | 10/15/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 235345 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207R00000X | 235345 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.