Provider Demographics
NPI:1902074388
Name:BALSAMINI, LAURA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:BALSAMINI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 ALEXANDRIA WAY
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-2763
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 PARSONS POND DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-2604
Practice Address - Country:US
Practice Address - Phone:917-842-2738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ024855183500000X
FL41838183500000X
CT10482183500000X
KY013878183500000X
NY044660183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ024855OtherRPH LICENSE NUMBER
CT0010482OtherRPH LICENSE NUMBER
PARP444618OtherLICENSE
OR0011639OtherLICENSE
KY013878OtherRPH LICENSE
NY044660OtherNY RPH LICENSE
HIPH-3063OtherLICENSE
FL41838OtherRPH LICENSE NUMBER