Active NPI
Laura Demarco
- Psychologist
- Hornell, NY
National Provider Identifier
1407937444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 011497
- Practice address
- 2 Bethesda Dr Ste 4
Hornell, NY 14843-1018 - Phone
- (607) 324-9240
- Fax
- (607) 324-9744
- NPI assigned
- Oct 18, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 011497 | NY | Primary |
Addresses
Primary practice location
2 Bethesda Dr Ste 4
Hornell, NY 14843-1018
Mailing address
2 Bethesda Dr Ste 4
Hornell, NY 14843-1018
Phone (607) 324-9240
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01474753 | Medicaid | NV | |
| 000511629006 | Other | NY | BLUE SHIELD WESTERN NY |
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101101000620 | NY | Practitioner - Clinical Psychologist | 8729272034 | Practice locations: Andover, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407937444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 BETHESDA DR STE 4",
"city": "HORNELL",
"state": "NY",
"postal_code": "148431018",
"telephone_number": "607-324-9240",
"fax_number": "607-324-9744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 BETHESDA DR STE 4",
"city": "HORNELL",
"state": "NY",
"postal_code": "148431018",
"telephone_number": "607-324-9240",
"fax_number": "607-324-9744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMARCO",
"first_name": "LAURA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "011497",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01474753",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD WESTERN NY",
"identifier": "000511629006",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hornell, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.