Provider Demographics
NPI:1548386717
Name:LAUREANO, SUGEI (MT)
Entity Type:Individual
Prefix:
First Name:SUGEI
Middle Name:
Last Name:LAUREANO
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:B6 CALLE 8
Mailing Address - Street 2:URB. ALTAMIRA
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-3615
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:B6 CALLE 8
Practice Address - Street 2:URB. ALTAMIRA
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-3615
Practice Address - Country:US
Practice Address - Phone:787-762-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6261246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist