Provider Demographics
NPI:1639446628
Name:SMALDONE ALSUP, LAURIE
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:
Last Name:SMALDONE ALSUP
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:LAURIE
Other - Middle Name:
Other - Last Name:SMALDONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:190 WOOSAMONSA RD
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-4002
Mailing Address - Country:US
Mailing Address - Phone:609-730-4980
Mailing Address - Fax:
Practice Address - Street 1:190 WOOSAMONSA RD
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-4002
Practice Address - Country:US
Practice Address - Phone:609-730-4980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-19
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT023852207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology