Laurencin, Samuel J

Laurencin, Samuel J is an individual health care provider with primary practice located at 500 Chase Pkwy , Waterbury CT 06708-3346. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Laurencin, Samuel J can be contacted via phone (203) 755-6677.

Contact Information

Primary practice address
500 Chase Pkwy Waterbury CT 06708-3346
Phone: (203) 755-6677
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 282565 Massachusetts
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 69456 Connecticut
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / General Practice 208D00000X 69456 Connecticut

Profile Details

NPI number 1508253998
LBN Legal business name Laurencin, Samuel J
Credentials MD, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2015
Last updated Feb 3rd, 2022 - about 3 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 1508253998 NPPES
Massachusetts MEDICAID 110162087A

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