Provider Demographics
NPI:1861016701
Name:LAUB, TALYA (RN, NP)
Entity type:Individual
Prefix:
First Name:TALYA
Middle Name:
Last Name:LAUB
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3 DELAWARE DR # 205
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1116
Mailing Address - Country:US
Mailing Address - Phone:516-608-2830
Mailing Address - Fax:516-622-6199
Practice Address - Street 1:3 DELAWARE DR # 205
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1116
Practice Address - Country:US
Practice Address - Phone:516-608-2830
Practice Address - Fax:516-622-6199
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-06
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY758360163W00000X
NY345966363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse