Individual
LAURA BOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
69 COUNTY RD 516, OLD BRIDGE, NJ 08857-1416
(732) 475-2150
(732) 475-2112
Mailing address
69 COUNTY RD 516, OLD BRIDGE, NJ 08857-1416
(732) 475-2150
(732) 475-2112
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
25MB10356200
NJ
Other
Enumeration date
12/19/2017
Last updated
08/02/2021
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