Provider Demographics
NPI:1851532113
Name:LAURA ELIA PROFESSIONAL SURGICAL SEVICES
Entity Type:Organization
Organization Name:LAURA ELIA PROFESSIONAL SURGICAL SEVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RNFA
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIA
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:201-230-4182
Mailing Address - Street 1:23-06 DORCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-2906
Mailing Address - Country:US
Mailing Address - Phone:201-230-4182
Mailing Address - Fax:201-794-4423
Practice Address - Street 1:23-06 DORCHESTER RD
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2906
Practice Address - Country:US
Practice Address - Phone:201-230-4182
Practice Address - Fax:201-794-4423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty