Laurentz, Robert

Laurentz, Robert is an sole proprietor health care provider with primary practice located at 207 E Court St , Ithaca NY 14850-4203. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Laurentz, Robert can be contacted via phone (607) 339-1757.

Contact Information

Primary practice address
207 E Court St Ithaca NY 14850-4203
Phone: (607) 339-1757
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 011909 New York
Behavioral Health & Social Service Providers / Clinical 103TC0700X 5008 Florida
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1835 Arizona
Behavioral Health & Social Service Providers / Clinical 103TC0700X 71004446 Illinois

Profile Details

NPI number 1497843437
LBN Legal business name Laurentz, Robert
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 11th, 2006
Last updated Jun 19th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497843437 NPPES
New York MEDICAID 01650279

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