Provider Demographics
NPI:1629303557
Name:SCZUREK, LAURA J (APRN)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:J
Last Name:SCZUREK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:JOY
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-2212
Mailing Address - Country:US
Mailing Address - Phone:860-679-7503
Mailing Address - Fax:860-679-1610
Practice Address - Street 1:1 ROYCE CIR
Practice Address - Street 2:SUITE 104
Practice Address - City:STORRS
Practice Address - State:CT
Practice Address - Zip Code:06268-2260
Practice Address - Country:US
Practice Address - Phone:860-487-9200
Practice Address - Fax:860-487-9222
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4193363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1629303557Medicaid