Individual provider Active NPI

Laura Demarco

  • Psychologist
  • Hornell, NY
National Provider Identifier
1407937444
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
011497 Issued in NY
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, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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
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

IdentifierTypeStateIssuer
01474753MedicaidNV
000511629006OtherNYBLUE 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Verify at the official NPI Registry.