Provider Demographics
NPI:1679867089
Name:REYDA, LAURA JOYCE (L AC)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:JOYCE
Last Name:REYDA
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 SOUTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-3211
Mailing Address - Country:US
Mailing Address - Phone:607-353-2499
Mailing Address - Fax:
Practice Address - Street 1:531 SOUTHSIDE DR
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-3211
Practice Address - Country:US
Practice Address - Phone:607-353-2499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25 004589171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist