Bevilacqua, Laura Marie

Bevilacqua, Laura Marie is an individual health care provider with primary practice located at 300 Longwood Ave , Boston MA 02115-5724. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is her primary health care specialty. Bevilacqua, Laura Marie can be contacted via phone (617) 355-6793.

Contact Information

Primary practice address
300 Longwood Ave Boston MA 02115-5724
Phone: (617) 355-6793
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 155889 Massachusetts
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X 155889 Massachusetts

Profile Details

NPI number 1700875507
LBN Legal business name Bevilacqua, Laura Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 14th, 2005
Last updated Sep 22nd, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700875507 NPPES
New Hampshire MEDICAID 30201468
New Hampshire Other 75-00451
New Hampshire MEDICAID 003136000
New Hampshire MEDICAID 2357326
New Hampshire Other J21189
New Hampshire MEDICAID 3198235
New Hampshire MEDICAID LB45398
New Hampshire MEDICAID 8753709
New Hampshire Other 99487301
New Hampshire Other J21189
New Hampshire Other AA9205

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