Healthcare Provider Details

I. General information

NPI: 1821783911
Provider Name (Legal Business Name): LAURA JUREWICZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3778 MEDINA RD
MEDINA OH
44256-5947
US

IV. Provider business mailing address

3778 MEDINA RD
MEDINA OH
44256-5947
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-2778
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number58.033415
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number34.018534
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: