Provider Demographics
NPI:1639304611
Name:ROOK, LAURA ANN (LAC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ANN
Last Name:ROOK
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:ANN
Other - Last Name:REPETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSLAC
Mailing Address - Street 1:1200 EAGLE AVE
Mailing Address - Street 2:2 ND FLR
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-7631
Mailing Address - Country:US
Mailing Address - Phone:732-660-6220
Mailing Address - Fax:
Practice Address - Street 1:5 PINE LN
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-7243
Practice Address - Country:US
Practice Address - Phone:808-561-8869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00061900171100000X
HIACU-758171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist