Provider Demographics
NPI:1295148617
Name:RABIDEAU, LAURA ABOITIZ (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ABOITIZ
Last Name:RABIDEAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 WALNUT ST STE 201
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2188
Mailing Address - Country:US
Mailing Address - Phone:781-237-3395
Mailing Address - Fax:
Practice Address - Street 1:65 WALNUT ST STE 201
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-2188
Practice Address - Country:US
Practice Address - Phone:781-237-3395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA271062207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine