Active NPI
Laura Ann Mydlowski
- Other Technician
- Virginia Beach, VA
National Provider Identifier
1619368982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 0230017840
- Practice address
- 1605 Bridle Creek CT
Virginia Beach, VA 23464-8525 - Phone
- (757) 619-1724
- NPI assigned
- Feb 9, 2015
- 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 |
|---|---|---|---|---|
| Other Technician | 247200000X | 0230017840 | VA | Primary |
Addresses
Primary practice location
1605 Bridle Creek CT
Virginia Beach, VA 23464-8525
Mailing address
1605 Bridle Creek CT
Virginia Beach, VA 23464-8525
Phone (757) 619-1724
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0230017840 | VA | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423440000000",
"number": "1619368982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1605 BRIDLE CREEK CT",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234648525",
"telephone_number": "757-619-1724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1605 BRIDLE CREEK CT",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234648525",
"telephone_number": "757-619-1724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYDLOWSKI",
"first_name": "LAURA",
"middle_name": "ANN",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-09",
"last_updated": "2015-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "VA",
"license": "0230017840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.