Provider Demographics
NPI:1023109758
Name:LAUREANO, ALBERTO N (MD)
Entity type:Individual
Prefix:
First Name:ALBERTO
Middle Name:N
Last Name:LAUREANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 NICHOLASVILLE RD
Mailing Address - Street 2:STE 500
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1404
Mailing Address - Country:US
Mailing Address - Phone:859-278-1114
Mailing Address - Fax:859-277-0541
Practice Address - Street 1:1720 NICHOLASVILLE ROAD
Practice Address - Street 2:SUITE 500
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503
Practice Address - Country:US
Practice Address - Phone:859-278-1114
Practice Address - Fax:859-277-0541
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY29534207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64295348Medicaid
KY0169Medicare PIN
F57244Medicare UPIN
KY0383904Medicare PIN
KY1503405Medicare PIN