Healthcare Provider Details

I. General information

NPI: 1609889211
Provider Name (Legal Business Name): LAURALEE M PAKOZDI MS,PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 CHURCH ST
FLEMINGTON NJ
08822-2197
US

IV. Provider business mailing address

215 STATE ROUTE 31 RM 116
FLEMINGTON NJ
08822-5752
US

V. Phone/Fax

Practice location:
  • Phone: 908-237-4124
  • Fax:
Mailing address:
  • Phone: 908-284-1125
  • Fax: 908-284-2016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number25MP00162300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number25MP00162300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: