Healthcare Provider Details

I. General information

NPI: 1013995208
Provider Name (Legal Business Name): LAURA ANN GARELICK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 09/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 NORTH ST FAMILY PRACTICE ASSOCIATES
MEDFIELD MA
02052-1654
US

IV. Provider business mailing address

637 GORWIN DR
HOLLISTON MA
01746-1595
US

V. Phone/Fax

Practice location:
  • Phone: 508-359-1519
  • Fax: 508-359-4345
Mailing address:
  • Phone: 508-429-3934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number156298
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: