Provider Demographics
NPI:1962239400
Name:KURUCZ, LAURIENNA S
Entity type:Individual
Prefix:
First Name:LAURIENNA
Middle Name:S
Last Name:KURUCZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LU
Other - Middle Name:S
Other - Last Name:KURUCZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1010 MASSACHUSETTS AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2853
Mailing Address - Country:US
Mailing Address - Phone:617-534-4222
Mailing Address - Fax:
Practice Address - Street 1:25 JAMES ONEILL ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-4504
Practice Address - Country:US
Practice Address - Phone:617-534-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health