Healthcare Provider Details

I. General information

NPI: 1548550650
Provider Name (Legal Business Name): LAURA P MCLAFFERTY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2011
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 SANSOM ST THOMPSON BUILDING, SUITE 1652
PHILADELPHIA PA
19107-5002
US

IV. Provider business mailing address

1020 SANSOM ST THOMPSON BUILDING, SUITE 1652
PHILADELPHIA PA
19107-5002
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-9545
  • Fax:
Mailing address:
  • Phone: 215-955-9545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number01080444A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME136827
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number51673
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberE-11840
License Number StateAR
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2018021514
License Number StateMO
# 6
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number081106
License Number StateGA
# 7
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number310185
License Number StateLA
# 8
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number57990
License Number StateTN
# 9
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD448273
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: