Provider Demographics
NPI:1386709731
Name:DUFFY, LAURIE F (MS)
Entity type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:F
Last Name:DUFFY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 ANN LN
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-2002
Mailing Address - Country:US
Mailing Address - Phone:401-885-4377
Mailing Address - Fax:401-737-1740
Practice Address - Street 1:200 TOLL GATE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4440
Practice Address - Country:US
Practice Address - Phone:401-737-1760
Practice Address - Fax:401-737-1740
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI000070231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI45-00030OtherUNITED HEALTHCARE
RI45-00093OtherEVERCARE
RI7836-2OtherBLUE CROSS AND BLUE SHIEL
RI404343OtherBLUE CHIP
RI9007836Medicaid