1730521790 NPI number — MRS. ADRIENNE BETH LAIRD APN

Table of content: MRS. ADRIENNE BETH LAIRD APN (NPI 1730521790)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730521790 NPI number — MRS. ADRIENNE BETH LAIRD APN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAIRD
Provider First Name:
ADRIENNE
Provider Middle Name:
BETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730521790
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/25/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
121 HIGHWAY 31, SUITE 1200
Provider Second Line Business Mailing Address:
HUNTERDON MEDICAL CENTER D/B/A HUNTERDON UROLOGICAL ASS
Provider Business Mailing Address City Name:
FLEMINGTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08822
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-782-0019
Provider Business Mailing Address Fax Number:
908-782-0630

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
121 HIGHWAY 121, SUITE 1200
Provider Second Line Business Practice Location Address:
HUNTERDON MEDICAL CENTER D/B/A HUNTERDON UROLOGICAL ASS
Provider Business Practice Location Address City Name:
FLEMINGTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-782-0019
Provider Business Practice Location Address Fax Number:
908-782-0630
Provider Enumeration Date:
07/19/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  26NJ00558100 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)