Healthcare Provider Details

I. General information

NPI: 1245624097
Provider Name (Legal Business Name): LAURA ELIZABETH PIPER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA ELIZABETH LARUSSO

II. Dates (important events)

Enumeration Date: 03/18/2015
Last Update Date: 04/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE # MLC9016
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE # MLC9016
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-803-8092
  • Fax: 513-803-9245
Mailing address:
  • Phone: 513-803-8092
  • Fax: 513-803-9245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberQ9478
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA128586
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.133961
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: