Provider Demographics
NPI:1659666790
Name:LABRUNO, LAURA A (APN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:LABRUNO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 STUYVESANT AVE
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2617
Mailing Address - Country:US
Mailing Address - Phone:201-933-0663
Mailing Address - Fax:
Practice Address - Street 1:48 ESSEX ST
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1607
Practice Address - Country:US
Practice Address - Phone:973-218-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00171900363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics