Provider Demographics
NPI:1265026397
Name:LAURIA, JEFFREY (MS, PHD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:LAURIA
Suffix:
Gender:M
Credentials:MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 SULLIVANT AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-1837
Mailing Address - Country:US
Mailing Address - Phone:614-655-8956
Mailing Address - Fax:614-748-0569
Practice Address - Street 1:3225 SULLIVANT AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-1837
Practice Address - Country:US
Practice Address - Phone:614-655-8956
Practice Address - Fax:614-748-0569
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator