Individual
LINDA ANN LAURETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1153 CENTRE ST, SUITE 43, JAMAICA PLAIN, MA 02130-3446
(617) 522-7041
(617) 522-3941
Mailing address
75 FRANCIS ST, BOSTON, MA 02115-6110
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
79442
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079442
TUFTS
MA
05
—
3125378
—
MA
01
—
64381
HARVARD PILGRIM
MA
01
—
J30804
BLUE CROSS
MA
Enumeration date
05/05/2006
Last updated
11/01/2019
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