Most Relevant Information
Provider Data
| NPI Number: | 1003554312 |
| Provider Name: | LAUREN CAPUA |
| Entity Type: | Individual |
| Taxonomy Code: | 2355A2700X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/25/2022 |
| Last Updated: | 05/25/2022 |
Provider Practice Location
50 BROADWAY
NEW YORK
NY
100041607
Practice Location Phone/Fax
| Phone: | 9173057700 |
| Fax: |
Provider Mailing Location
186 SHIEL AVE
STATEN ISLAND
NY
103094280
Provider Mailing Phone/Fax
| Phone: | 9174148499 |
| Fax: |