Provider Demographics
NPI:1831460880
Name:DENNER, LAURA A (RPH)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:DENNER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 MARCELLUS DR # 3
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2012
Mailing Address - Country:US
Mailing Address - Phone:908-232-6774
Mailing Address - Fax:
Practice Address - Street 1:745 MARCELLUS DR # 3
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2012
Practice Address - Country:US
Practice Address - Phone:908-232-6774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02087500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist