Individual
JOHN LAURIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
833 CHESTNUT ST STE 210, PHILADELPHIA, PA 19107-4405
(215) 955-6913
Mailing address
833 CHESTNUT ST STE 210, PHILADELPHIA, PA 19107-4405
(215) 955-6913
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2009006926
MO
2084P0800X
Psychiatry Physician
94-296
NM
Other
Enumeration date
08/01/2006
Last updated
11/21/2019
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