Individual
MRS. LAURA AMANDA PINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
147 E 3RD ST, SUITE 2, MOORESTOWN, NJ 08057-2924
(856) 234-2500
(856) 234-3907
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
008803
NY
363A00000X
Physician Assistant
Primary
25MP00097800
NJ
363A00000X
Physician Assistant
MA053350
PA
Other
Enumeration date
12/15/2005
Last updated
10/16/2020
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