Provider Demographics
NPI:1356343099
Name:KAROSAS, LAIMA M (PHD, APRN)
Entity type:Individual
Prefix:MRS
First Name:LAIMA
Middle Name:M
Last Name:KAROSAS
Suffix:
Gender:F
Credentials:PHD, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 OAKGATE DR
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-6135
Mailing Address - Country:US
Mailing Address - Phone:203-435-5359
Mailing Address - Fax:
Practice Address - Street 1:400 CAPITAL BLVD FL 3
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-3576
Practice Address - Country:US
Practice Address - Phone:860-227-4122
Practice Address - Fax:866-351-7078
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN01591363LA2200X
NY308172363LA2200X
CT000762363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004221298Medicaid
CT500024089OtherRR MEDICARE
CT500024089OtherRR MEDICARE
CT500000781Medicare ID - Type Unspecified