Provider Demographics
NPI:1407852726
Name:BOND, LAURA R (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:R
Last Name:BOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ROBERT WOOD JOHNSON PL
Mailing Address - Street 2:RUTGERS-RWJ RADIATION ONCOLOGY
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1928
Mailing Address - Country:US
Mailing Address - Phone:732-235-6572
Mailing Address - Fax:732-235-5260
Practice Address - Street 1:30 REHILL AVE STE 1100
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2545
Practice Address - Country:US
Practice Address - Phone:908-769-5909
Practice Address - Fax:908-927-8764
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06058800174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6199003Medicaid
NJF82784Medicare UPIN
NJ6199003Medicaid