Provider Demographics
NPI:1710205489
Name:BRAUN, LAURIE ROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:ROSE
Last Name:BRAUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURIE
Other - Middle Name:ROSE
Other - Last Name:HANDWERKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:157 PLEASANT ST APT 209
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4656
Mailing Address - Country:US
Mailing Address - Phone:516-642-4330
Mailing Address - Fax:617-730-0335
Practice Address - Street 1:1 LONG WHARF DR STE 503
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5593
Practice Address - Country:US
Practice Address - Phone:877-925-3637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA254309208000000X, 2080P0205X
CT699032080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics