Provider Demographics
NPI:1235663824
Name:SENATORE, LAURAL DIANE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:LAURAL
Middle Name:DIANE
Last Name:SENATORE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 PLYMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-1605
Mailing Address - Country:US
Mailing Address - Phone:973-227-7105
Mailing Address - Fax:973-882-8950
Practice Address - Street 1:86 PLYMOUTH ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-1605
Practice Address - Country:US
Practice Address - Phone:973-227-7105
Practice Address - Fax:973-882-8950
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY341716363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily