NPIMap

Organization Active NPI

Laura Coudrey, M.D., P.C.

  • Cardiovascular Disease Physician
  • Bay Shore, NY
National Provider Identifier
1376584672
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
200075 Issued in NY
Legal business name
LAURA COUDREY, M.D., P.C.
Practice address
3 E Main St
Bay Shore, NY 11706-8303
Phone
(631) 666-2290
Fax
(631) 666-2283
NPI assigned
Jun 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Laura Coudrey, M.D.
Title
President
Phone
(631) 666-2290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X 200075 NY Primary

Addresses

Primary practice location

3 E Main St
Bay Shore, NY 11706-8303

Mailing address

3 E Main St
Bay Shore, NY 11706-8303
Phone (631) 666-2290

Other identifiers 1

IdentifierTypeStateIssuer
02263954MedicaidNY

National Provider Directory

National Provider Directory

Locations

3 E Main St
Bay Shore, NY 11706
Phone (631) 666-2290

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376584672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068303",
            "telephone_number": "631-666-2290",
            "fax_number": "631-666-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068303",
            "telephone_number": "631-666-2290",
            "fax_number": "631-666-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA COUDREY, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COUDREY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-666-2290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "200075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02263954",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.