MEDICARE: LAURIE J DEERFIELD DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	OS8079	FL
2	2084P0800X	Psychiatry Physician	DO3156	ME
3	2084P0800X	Psychiatry Physician	25MB07419	NJ

General Provider Information

NPI Number	:	1689676207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE J DEERFIELD DO

Provider Business Mailing Address
First Line	:	241 RIVERSIDE DR
Second Line	:	UNIT 1907
City	:	HOLLY HILL
State	:	FL
Zip	:	32117
Country	:	US
Telephone Number	:	856-397-3970
Fax Number	:	856-397-3970

Provider Business Practice Location Address
First Line	:	241 RIVERSIDE DR
Second Line	:	UNIT 1907
City	:	HOLLY HILL
State	:	FL
Zip	:	32117
Country	:	US
Telephone Number	:	856-397-3970
Fax Number	:	856-397-3970

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	08/08/2025

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