Individual
MS. LAUREN M CANOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9 PROFESSIONAL CIRCLE, SUITE 101, COLTS NECK, NJ 07722-2427
(732) 431-1520
Mailing address
9 PROFESSIONAL CIR, SUITE 101, COLTS NECK, NJ 07722-2427
(732) 431-1520
(732) 431-1567
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
010022
NY
363AM0700X
Medical Physician Assistant
Primary
25MP000305900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02634811
—
NY
Enumeration date
12/14/2005
Last updated
07/02/2013
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