Provider Demographics
NPI:1316120058
Name:DAIGLE, LAURA S (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:S
Last Name:DAIGLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:891 ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-1744
Mailing Address - Country:US
Mailing Address - Phone:518-366-5593
Mailing Address - Fax:
Practice Address - Street 1:891 ROUTE 9
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-1744
Practice Address - Country:US
Practice Address - Phone:518-366-5593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist