Laura Ellen Antonelli, MA

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

Practice address

998 Crooked Hill Rd
BLDG 56
Brentwood, NY 11717-1019

Phone

(631) 761-3394

NPI assigned

Dec 21, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Laura Ellen Grogan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1265897086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 CROOKED HILL RD",
            "address_2": "BLDG 56",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117171019",
            "telephone_number": "631-761-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 CROOKED HILL RD",
            "address_2": "BLDG 56",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117171019",
            "telephone_number": "631-761-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONELLI",
        "first_name": "LAURA",
        "middle_name": "ELLEN",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "GROGAN",
            "middle_name": "ELLEN",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marieandree Ambroise
• Tracyann Anderson
• Amanda Lynn Andersson
• Godfred Ankomah
• Tasheya Anthony
• Ruth O. Anyah
• Maria P Aponte, BS,CDN,RD
• Mindy Frumin Arce, LCAT
• Anthony J Argueta
• Paris A Arianas, MD

• Forensic Psychologist in Brentwood, NY
• Providers in Brentwood, NY by specialty
• Forensic Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.