Individual
JACQUELYN LAURIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
195 LITTLE ALBANY ST, CANCER INSTITUTE OF NEW JERSEY, NEW BRUNSWICK, NJ 08901-1914
(732) 235-4986
(732) 235-3299
Mailing address
66 W GILBERT ST, 2ND FLOOR, REDBANK, NJ 07701
(732) 212-0051
(732) 212-0713
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NR102955
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0075256
—
NJ
Enumeration date
01/17/2007
Last updated
05/15/2009
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