Provider Demographics
NPI:1447517057
Name:WINSTEN-SCHWARTZ, LAURA (MS)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:WINSTEN-SCHWARTZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 THE VALE
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4312
Mailing Address - Country:US
Mailing Address - Phone:917-566-7316
Mailing Address - Fax:516-496-9480
Practice Address - Street 1:176 THE VALE
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4312
Practice Address - Country:US
Practice Address - Phone:917-566-7316
Practice Address - Fax:516-496-9480
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171W00000X
NY174400000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171W00000XOther Service ProvidersContractor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator