| Doctor Name: | LAURA LYNN DEMARIA |
| NPI Number: | 1174803209 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | 26NN10015900 |
| Business Practice Address: | 180 South St 2nd Floor New Providence, NJ - 079741991 |
| Business Phone Number: | 9087719824 |
| Business Fax Number: | |
| Mailing Address: | 180 South St, 2nd Floor NEW PROVIDENCE |
| State: | NJ |
| Postal Code: | 079741991 |
| Phone Number: | 9087719824 |
| Fax Number: | |
| NPI Enumeration Date: | 08/21/2011 |
| NPI Last Update Date: | 08/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 26NN10015900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |