Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 25MA10608600 | NJ |
NPI | 1245673912 |
---|---|
Provider Name | Kathryn Loughlin Laurie |
First Address | Boston, MA 02241-6457 |
Second Address | Morristown, NJ 07960-6136 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2013 |
Last Update Date | 16/10/2019 |