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General NPI Number Information
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NPI Number | 1376991018
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Entity Type | Individual
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Provider Name | LAURA CORAL PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 99 CHELMSFORD RD STE 8
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City | NORTH BILLERICA
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State | MA
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Zip | 01862-1351
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Country | US
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Telephone | 978-970-6661
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Fax |
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Provider Business Mailing Address
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Address Line | 42 SPAULDING RD
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City | CHELMSFORD
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State | MA
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Zip | 01824-1053
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Country | US
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Telephone | 978-888-7078
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA6528
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License Number State | MA
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