Provider Demographics
NPI:1831358639
Name:LAUER-PFROMMER, MARIA ELAINA (PHD, APN-BC, RN, CNE)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ELAINA
Last Name:LAUER-PFROMMER
Suffix:
Gender:F
Credentials:PHD, APN-BC, RN, CNE
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:E
Other - Last Name:LAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, APN-BC, RN, CNE
Mailing Address - Street 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ01332576363LF0000X
NJ26NJ00162200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ125239XVAMedicare UPIN