Provider Demographics
NPI:1003125634
Name:ALONZO, LAURIE L (RN)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:L
Last Name:ALONZO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WOOD RD
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-2216
Mailing Address - Country:US
Mailing Address - Phone:518-884-7270
Mailing Address - Fax:
Practice Address - Street 1:100 WOOD RD
Practice Address - Street 2:
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-2216
Practice Address - Country:US
Practice Address - Phone:518-884-7270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY453866-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool