Provider Demographics
NPI:1649468828
Name:BRASLOW, LAURA A (PA)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:BRASLOW
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:2101 EMRICK BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020
Practice Address - Country:US
Practice Address - Phone:610-868-4000
Practice Address - Fax:610-868-4033
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2018-08-30
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Provider Licenses
StateLicense IDTaxonomies
PAMA001630L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical