Provider Demographics
NPI:1366749772
Name:BOND, LAURA LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:BOND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LYNN
Other - Last Name:TAMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:50 POMPTON AVE
Mailing Address - Street 2:FIRST CARE MEDICAL GROUP
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044
Mailing Address - Country:US
Mailing Address - Phone:973-857-3400
Mailing Address - Fax:
Practice Address - Street 1:400 WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-1621
Practice Address - Country:US
Practice Address - Phone:908-691-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant