Provider Demographics
NPI:1598072100
Name:LAQUI, MARIA (RN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:LAQUI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 SPRUCE DR STE 2
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-2221
Mailing Address - Country:US
Mailing Address - Phone:908-731-7099
Mailing Address - Fax:
Practice Address - Street 1:1139 SPRUCE DR STE 2
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2221
Practice Address - Country:US
Practice Address - Phone:908-731-7099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF402515-1363LP0808X
NJ26NJ00827800363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health