Provider Demographics
NPI:1851818421
Name:DEMAIO, LAUREN PAULA
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:PAULA
Last Name:DEMAIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6136 75TH PL
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-1220
Mailing Address - Country:US
Mailing Address - Phone:347-387-1746
Mailing Address - Fax:
Practice Address - Street 1:7130 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7260
Practice Address - Country:US
Practice Address - Phone:718-456-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist