Provider Demographics
NPI:1902902489
Name:TAYLOR, LAUREL MARIE
Entity Type:Individual
Prefix:MRS
First Name:LAUREL
Middle Name:MARIE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 FRANCIS ST
Mailing Address - Street 2:BRIGHAM & WOMEN'S, TOWER 3A, CARDIAC ARRHYTHMIA
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:BRIGHAM & WOMEN'S, TOWER 3A, CARDIAC ARRHYTHMIA
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-6660
Practice Address - Fax:617-264-5233
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAAP1155363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant