Healthcare Provider Details

I. General information

NPI: 1629001441
Provider Name (Legal Business Name): LAURIE A CONTI O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28322 LEWES GEORGETOWN HWY
MILTON DE
19968-3117
US

IV. Provider business mailing address

PO BOX 58
NASSAU DE
19969-0058
US

V. Phone/Fax

Practice location:
  • Phone: 302-684-2020
  • Fax: 302-684-2021
Mailing address:
  • Phone: 302-684-2020
  • Fax: 302-684-2021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number13-0001310
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: