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General NPI Number Information
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NPI Number | 1184854820
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Entity Type | Individual
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Provider Name | JOHN A LAURINO D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 07/15/2009
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Last Update Date | 07/15/2009
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Provider Practice Location Address
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Address Line | 23 PARKER RD
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City | WEST LONG BRANCH
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State | NJ
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Zip | 07764-1137
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Country | US
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Telephone | 908-433-9474
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Fax |
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Provider Business Mailing Address
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Address Line | 23 PARKER RD
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City | WEST LONG BRANCH
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State | NJ
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Zip | 07764-1137
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Country | US
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Telephone | 908-433-9474
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 25MD00271300
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License Number State | NJ
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