Provider Demographics
NPI:1891729539
Name:LAEMMLE, PATRICIA CUNNINGHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:CUNNINGHAM
Last Name:LAEMMLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:CUNNINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1810 ENGLISHTOWN RD
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857
Mailing Address - Country:US
Mailing Address - Phone:732-416-6900
Mailing Address - Fax:732-416-4823
Practice Address - Street 1:1810 ENGLISHTOWN RD
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857
Practice Address - Country:US
Practice Address - Phone:732-416-6900
Practice Address - Fax:732-416-4823
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA64740207R00000X
NJ25MA064740207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7787103Medicaid
NJ7787103Medicaid
NJ024235B8VMedicare PIN