Basic Information
| Provider Information | |||||||||
| NPI: | 1023457850 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAURIA | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | MILDRED | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 455 TOLL GATE RD | ||||||||
| Address2: | OFFICE OF GRADUATE MEDICAL EDUCATION | ||||||||
| City: | WARWICK | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028862759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017317000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 455 TOLL GATE RD | ||||||||
| Address2: | OFFICE OF GRADUATE MEDICAL EDUCATION | ||||||||
| City: | WARWICK | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028862759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017317000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2013 | ||||||||
| LastUpdateDate: | 02/28/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | LP02740 | RI | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207P00000X | DO00858 | RI | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.