Laura Lee Davis

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

642631 Issued in NY

Practice address

4800 Pequash Ave
Cutchogue, NY 11935-2261

Phone

(631) 413-8424

NPI assigned

Apr 14, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1467742130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 PEQUASH AVE",
            "city": "CUTCHOGUE",
            "state": "NY",
            "postal_code": "119352261",
            "telephone_number": "631-413-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 PEQUASH AVE",
            "city": "CUTCHOGUE",
            "state": "NY",
            "postal_code": "119352261",
            "telephone_number": "631-413-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LAURA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-14",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "205473-1",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "VA",
            "license": "0002065898",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "642631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cutchogue Barths Pharmacy Inc
• Cutchogue Drug Store
• Cutchogue Internal Medicine, PLLC
• Cutchogue Walk-in Medical Care PLLC
• Scott Z Czujko, DPT
• Lorraine Dibble, P.T.
• Diana Falkenbach, PH.D.
• Emma Rose Fasolino
• Five Branches Acupuncture and Massage Studio
• Maryann Fleischman, LCSWR

• Registered Nurse in Cutchogue, NY
• Providers in Cutchogue, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.