Provider Demographics
NPI:1891898292
Name:ROSS-ADAMS, LAURA ELLEN (DO)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELLEN
Last Name:ROSS-ADAMS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:ELLEN
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 RED FEATHER CT
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8331
Mailing Address - Country:US
Mailing Address - Phone:609-953-8824
Mailing Address - Fax:
Practice Address - Street 1:300 CREEK CROSSING BLVD.
Practice Address - Street 2:SUITE 307
Practice Address - City:HAINESPORT
Practice Address - State:NJ
Practice Address - Zip Code:08036
Practice Address - Country:US
Practice Address - Phone:609-267-2333
Practice Address - Fax:609-267-2533
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB064032207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Not Answered207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0014526000OtherIBC
PA1147618OtherAETNA
NJ0014526000OtherIBC