Provider Demographics
NPI:1881698694
Name:LAUFFENBURGER, REBECCA J (OD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:J
Last Name:LAUFFENBURGER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:961 DOVER RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-4105
Mailing Address - Country:US
Mailing Address - Phone:330-262-0028
Mailing Address - Fax:330-262-2808
Practice Address - Street 1:961 DOVER RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-4105
Practice Address - Country:US
Practice Address - Phone:330-262-0028
Practice Address - Fax:330-262-2808
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5487152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHV04623Medicare UPIN
OHLA4155321Medicare PIN