Individual provider Active NPI

Tara Laurenzi, LMT, RYT

  • Mechanotherapist
  • Buffalo, NY
National Provider Identifier
1457768962
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
011411-1 Issued in NY
Practice address
752 Ashland Ave
Buffalo, NY 14222-1120
Phone
(716) 308-4285
NPI assigned
Jul 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X 011411-1 NY Primary

Addresses

Primary practice location

752 Ashland Ave
Buffalo, NY 14222-1120

Mailing address

752 Ashland Ave
Buffalo, NY 14222-1120
Phone (716) 308-4285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
011411-1NYMDMechanotherapist

NPI Registry JSON

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1457768962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 ASHLAND AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142221120",
            "telephone_number": "716-308-4285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "752 ASHLAND AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142221120",
            "telephone_number": "716-308-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURENZI",
        "first_name": "TARA",
        "name_prefix": "Miss",
        "credential": "LMT, RYT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "NY",
            "license": "011411-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.