MEDICARE: LAURENTE MEDICAL ASSOCIATES, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	23982	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548444235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAURENTE MEDICAL ASSOCIATES, P.A.

Provider Business Mailing Address
First Line	:	4453 NOTTINGHAM WAY
Second Line	:
City	:	HAMILTON SQUARE
State	:	NJ
Zip	:	08690-3815
Country	:	US
Telephone Number	:	609-587-0119
Fax Number	:	609-587-3009

Provider Business Practice Location Address
First Line	:	4453 NOTTINGHAM WAY
Second Line	:
City	:	HAMILTON SQUARE
State	:	NJ
Zip	:	08690-3815
Country	:	US
Telephone Number	:	609-587-0119
Fax Number	:	609-587-3009

Authorized Official
Title or Position	:	OWNER
Name	:	ROMEO LAURENTE
Credential	:
Telephone Number	:	609-587-0119

Provider Enumeration Date	:	12/18/2007
Last Update Date	:	12/18/2007

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