Basic Information
| Provider Information | |||||||||
| NPI: | 1023082757 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BESSETTE | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 630 PLANTATION ST | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085952300 | ||||||||
| FaxNumber: | 5088535226 | ||||||||
| Practice Location | |||||||||
| Address1: | 630 PLANTATION ST | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085952300 | ||||||||
| FaxNumber: | 5088535226 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2006 | ||||||||
| LastUpdateDate: | 01/27/2009 | ||||||||
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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 | 207R00000X | 78564 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 26750 | 01 | CHILDRENS MEDICAL SECURIT | OTHER | 991108 | 01 | FALLON COMMUNITY HEALTH P | OTHER | 042472266 | 01 | PRIVATE HEALTHCARE SYSTEM | OTHER | 26750 | 01 | HEALTHY START | OTHER | 784116 | 01 | MVP HEALTH CARE | OTHER | 1059578 | 01 | FIRST HEALTH | OTHER | AA1191 | 01 | HARVARD PILGRIM HEALTHCAR | OTHER | 042472266 | 01 | HEALTHCARE VALUE MANAGEME | OTHER | 3509969 | 01 | CIGNA HEALTH PLAN | OTHER | 7436307 | 01 | AETNA US HEALTHCARE | OTHER | 3128857 | 01 | MEDICAID WELFARE | OTHER | 042472266 | 01 | ONE HEALTH PLAN | OTHER | J14545 | 01 | BLUE CARE ELECT | OTHER | 0401151 | 01 | EVERCARE | OTHER | 3128857 | 05 | MA | MEDICAID | J14545 | 01 | BLUE SHIELD HMO BLUE | OTHER | J14545 | 01 | BLUE SHIELD INDEMNITY | OTHER |