Provider Information for 1134881345
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LAURIE PETER
Sex: Female
NPI: 1134881345
Last Updated: 2021-10-06
Certification Date: 2021-10-06
Certification Date: 2021-10-06
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1134881345 | ||||||||||||
| Enumeration Date | 2021-10-06 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 40 SHALEBROOK DR MORRISTOWN, NJ 07960-6638 United States Phone: 908-500-8438 | Fax:973-425-0824 | ||||||||||||
| Primary Practice Address | 40 SHALEBROOK DR MORRISTOWN, NJ 07960-6638 United States Phone: 908-500-8438 | Fax:973-425-0824 | ||||||||||||
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