Provider Demographics
NPI:1285263061
Name:DO OURO-RODRIGUES, LARYSSA (MD)
Entity type:Individual
Prefix:
First Name:LARYSSA
Middle Name:
Last Name:DO OURO-RODRIGUES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 1ST AVE APT 31E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2362
Mailing Address - Country:US
Mailing Address - Phone:516-526-4828
Mailing Address - Fax:
Practice Address - Street 1:36 W 44TH ST STE 600B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-8112
Practice Address - Country:US
Practice Address - Phone:917-299-8256
Practice Address - Fax:646-661-3963
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-03
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336585208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty