Provider Demographics
NPI:1952494940
Name:JANES, LAURA CHRISTINE (DO)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:CHRISTINE
Last Name:JANES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2363
Mailing Address - Country:US
Mailing Address - Phone:609-653-2101
Mailing Address - Fax:609-653-2247
Practice Address - Street 1:750 SHORE RD
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2363
Practice Address - Country:US
Practice Address - Phone:609-653-2101
Practice Address - Fax:609-653-2247
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB66302207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH00147Medicare UPIN