# LAURA MARIE BEVILACQUA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1700875507
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | 155889 | MA | Yes |
| 208000000X | Pediatrics Physician | 155889 | MA | — |

## Other

- **Enumeration date:** 10/14/2005
- **Last updated:** 09/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003136000 | — | CT |
| 05 | — | 2357326 | — | NY |
| 05 | — | 30201468 | — | NH |
| 05 | — | 3198235 | — | MA |
| 01 | — | 75-00451 | UNITED HEALTHCARE MA | MA |
| 05 | — | 8753709 | — | NJ |
| 01 | — | 99487301 | NETWORK HEALTH | MA |
| 01 | — | AA9205 | HARVARD PILGRIM | MA |
| 01 | — | J21189 | HMO BLUE | MA |
| 05 | — | LB45398 | — | RI |