Provider Demographics
NPI:1730333733
Name:LAURIA, RENEE (RPH)
Entity type:Individual
Prefix:MS
First Name:RENEE
Middle Name:
Last Name:LAURIA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-5193
Mailing Address - Country:US
Mailing Address - Phone:781-486-0000
Mailing Address - Fax:
Practice Address - Street 1:15 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-5193
Practice Address - Country:US
Practice Address - Phone:781-486-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23078183500000X
RIRPH03839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist