Provider Demographics
NPI:1194182519
Name:MATURO, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MATURO
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 1:5353 AZTEC DR
Mailing Address - Street 2:#4
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-2114
Mailing Address - Country:US
Mailing Address - Phone:518-727-0810
Mailing Address - Fax:
Practice Address - Street 1:5353 AZTEC DR
Practice Address - Street 2:#4
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-2114
Practice Address - Country:US
Practice Address - Phone:518-727-0810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula