Provider Demographics
NPI:1700030277
Name:LAURANS, MONIKA S (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MONIKA
Middle Name:S
Last Name:LAURANS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:MONIKA
Other - Middle Name:S
Other - Last Name:SWIETEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:789 HOWARD AVE
Mailing Address - Street 2:TOMPKINS 4
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1304
Mailing Address - Country:US
Mailing Address - Phone:203-785-7284
Mailing Address - Fax:
Practice Address - Street 1:789 HOWARD AVE
Practice Address - Street 2:TOMPKINS 4
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1304
Practice Address - Country:US
Practice Address - Phone:203-785-7284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002187363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant