Provider Demographics
NPI:1417114695
Name:MCCULLOUGH, LAURA CECCHI (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:CECCHI
Last Name:MCCULLOUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:340 WOOD RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-2401
Mailing Address - Country:US
Mailing Address - Phone:781-356-6200
Mailing Address - Fax:781-356-6299
Practice Address - Street 1:340 WOOD RD
Practice Address - Street 2:SUITE 301
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-2401
Practice Address - Country:US
Practice Address - Phone:781-356-6200
Practice Address - Fax:781-356-6299
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2011-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA228621208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics