Herzog, Lara Kristine

Herzog, Lara Kristine is an individual health care provider with primary practice located at 48 Douglas Ln , East Aurora NY 14052-2124. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Herzog, Lara Kristine can be contacted via phone (716) 714-9860.

Contact Information

Primary practice address
48 Douglas Ln East Aurora NY 14052-2124
Phone: (716) 714-9860
Fax: (716) 714-9864
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 10948 Tennessee
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 7537 South Carolina
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 038070 New York

Profile Details

NPI number 1326445867
LBN Legal business name Herzog, Lara Kristine
Credentials PT, DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 26th, 2014
Last updated Apr 14th, 2021 - about 4 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 1326445867 NPPES
New York MEDICAID 05899665

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