Provider Demographics
NPI:1417609389
Name:TAPIA, LAURA (MEDICAL ASSISTANT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:TAPIA
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6618 S MOZART ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-2926
Mailing Address - Country:US
Mailing Address - Phone:773-968-6950
Mailing Address - Fax:
Practice Address - Street 1:106 APPLE ST STE 221
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-2670
Practice Address - Country:US
Practice Address - Phone:857-576-5191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst