Provider Demographics
NPI:1730386731
Name:TRIANO, LAURA R (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:R
Last Name:TRIANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 BELLEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-3709
Mailing Address - Country:US
Mailing Address - Phone:860-543-5188
Mailing Address - Fax:
Practice Address - Street 1:1062 FORSYTH ST
Practice Address - Street 2:SUITE 1-B
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-8637
Practice Address - Country:US
Practice Address - Phone:478-314-1658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT044604207RX0202X, 207RH0003X, 207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD400011212Medicare UPIN