Provider Demographics
NPI:1114056819
Name:GESSMAN, LAURA MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MICHELLE
Last Name:GESSMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1930 SOUTH BROAD STREET
Mailing Address - Street 2:UNIT 5
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-2304
Mailing Address - Country:US
Mailing Address - Phone:215-467-5870
Mailing Address - Fax:215-467-5873
Practice Address - Street 1:1930 S BROAD ST
Practice Address - Street 2:UNIT 5
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-2328
Practice Address - Country:US
Practice Address - Phone:215-467-5870
Practice Address - Fax:215-467-5873
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4343565208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics