Basic Information
Provider Information
NPI: 1760816425
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FUTRANSKY
FirstName: LAURA
MiddleName: J.
NamePrefix:  
NameSuffix:  
Credential: MSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 95000
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191954655
CountryCode: US
TelephoneNumber: 8004446020
FaxNumber: 8452561881
Practice Location
Address1: 50 E 168TH ST # 98
Address2:  
City: BRONX
State: NY
PostalCode: 104527929
CountryCode: US
TelephoneNumber: 7182933900
FaxNumber: 7182933980
Other Information
ProviderEnumerationDate: 08/29/2013
LastUpdateDate: 08/29/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000XP89240NYY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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