Healthcare Provider Details

I. General information

NPI: 1114907045
Provider Name (Legal Business Name): LAURA PRICE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 HALL DR SUITE 2
AMHERST MA
01002-2751
US

IV. Provider business mailing address

31 HALL DR SUITE 2
AMHERST MA
01002-2751
US

V. Phone/Fax

Practice location:
  • Phone: 413-253-3773
  • Fax: 413-256-0215
Mailing address:
  • Phone: 413-253-3773
  • Fax: 413-256-0215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number71719
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: