Basic Information
| Provider Information | |||||||||
| NPI: | 1669908950 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAGUERRE | ||||||||
| FirstName: | KRISTINA | ||||||||
| MiddleName: | JANE | ||||||||
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| Credential: | MD, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1865 ROUTE 70 E FL 2 | ||||||||
| Address2: | |||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080032005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8564274336 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1865 ROUTE 70 E FL 2 | ||||||||
| Address2: | |||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080032005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8564274336 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2017 | ||||||||
| LastUpdateDate: | 09/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD471559 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 25MA10873700 | NJ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.