Provider Demographics
NPI:1528932621
Name:LAGUATAN, BRIAN (APN)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:LAGUATAN
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BEACON PL
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3044
Mailing Address - Country:US
Mailing Address - Phone:732-890-4900
Mailing Address - Fax:
Practice Address - Street 1:7 BEACON PL
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3044
Practice Address - Country:US
Practice Address - Phone:732-890-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-01
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY407612363LP0808X
NY357946363LF0000X
NJ26NJ15370000363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily