Provider Demographics
NPI:1518280825
Name:PERRY, LAURA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 COUNTY ROUTE 68
Mailing Address - Street 2:
Mailing Address - City:EAGLE BRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:12057-2820
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8 KOCHER DR
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-1923
Practice Address - Country:US
Practice Address - Phone:802-442-8369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0003726183500000X
NY050871-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist