Provider Demographics
NPI:1215298351
Name:STEWART, LAURA PETRI (MA)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:PETRI
Last Name:STEWART
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 MONA DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4126
Mailing Address - Country:US
Mailing Address - Phone:716-833-6671
Mailing Address - Fax:
Practice Address - Street 1:29 MONA DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-4126
Practice Address - Country:US
Practice Address - Phone:716-833-6671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist