Individual
LAURA S PICCIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6100 MAIN STREET, THE RIPA CENTER, VOORHEES, NJ 08043-4660
(856) 673-4912
(856) 938-2077
Mailing address
100 E. LANCASTER AVE., SUITE 330 MOB WEST, WYNNEWOOD, PA 19096-3443
(610) 645-6555
(610) 649-4744
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MB07361900
NJ
207R00000X
Internal Medicine Physician
OS009621L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017809080001
—
PA
Enumeration date
02/01/2006
Last updated
12/05/2016
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