Healthcare Provider Details

I. General information

NPI: 1053934539
Provider Name (Legal Business Name): LAURA ELIZABETH SCHROEDER MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 JEFFERSON ST STE 210-216
HARTFORD CT
06106-2601
US

IV. Provider business mailing address

593 EDDY ST
PROVIDENCE RI
02903-4923
US

V. Phone/Fax

Practice location:
  • Phone: 860-696-5169
  • Fax:
Mailing address:
  • Phone: 401-444-5127
  • Fax: 401-444-3056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberLP04977
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number84164
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: