Provider Demographics
NPI:1033580725
Name:PILITSIS, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:PILITSIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:697 CAMBRIDGE ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2897
Mailing Address - Country:US
Mailing Address - Phone:857-399-5164
Mailing Address - Fax:
Practice Address - Street 1:697 CAMBRIDGE ST
Practice Address - Street 2:SUITE 204
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2897
Practice Address - Country:US
Practice Address - Phone:857-399-5164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist