Provider Demographics
NPI:1295045615
Name:CHUTE, LAUREL (OD)
Entity Type:Individual
Prefix:DR
First Name:LAUREL
Middle Name:
Last Name:CHUTE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:LAUREL
Other - Middle Name:
Other - Last Name:YANOF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:274 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3992
Practice Address - Country:US
Practice Address - Phone:413-584-6616
Practice Address - Fax:413-584-1951
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT030.0069780152W00000X
MAMA4958152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA003221301OtherMEDICARE
MA110095911AMedicaid