Individual provider Active NPI

Allen Steven Laub, M.D.

  • Pediatrics Physician
  • Garnerville, NY
National Provider Identifier
1003825258
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
097040 Issued in NY
Practice address
171 Ramapo Rd
Garnerville, NY 10923-1552
Phone
(845) 947-1772
Fax
(845) 947-4487
NPI assigned
Aug 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 097040 NY Primary

Addresses

Primary practice location

171 Ramapo Rd
Garnerville, NY 10923-1552

Mailing address

171 Ramapo Rd
Garnerville, NY 10923-1552
Phone (845) 947-1772

Other identifiers 1

IdentifierTypeStateIssuer
00417854MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140912001027 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6608095278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003825258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 RAMAPO RD",
            "city": "GARNERVILLE",
            "state": "NY",
            "postal_code": "109231552",
            "telephone_number": "845-947-1772",
            "fax_number": "845-947-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 RAMAPO RD",
            "city": "GARNERVILLE",
            "state": "NY",
            "postal_code": "109231552",
            "telephone_number": "845-947-1772",
            "fax_number": "845-947-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUB",
        "first_name": "ALLEN",
        "middle_name": "STEVEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "097040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00417854",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garnerville, NY

Sources for this page

Verify at the official NPI Registry.