Basic Information
Provider Information
NPI: 1891792578
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAIR
FirstName: LAURA
MiddleName: G
NamePrefix: MS.
NameSuffix:  
Credential: MPT, CHT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2408 WHITNEY AVE
Address2:  
City: HAMDEN
State: CT
PostalCode: 065183209
CountryCode: US
TelephoneNumber: 2036260160
FaxNumber: 2032946734
Practice Location
Address1: 9 WASHINGTON AVE FL 1-A
Address2:  
City: HAMDEN
State: CT
PostalCode: 065183267
CountryCode: US
TelephoneNumber: 2037898873
FaxNumber: 2034668527
Other Information
ProviderEnumerationDate: 07/07/2005
LastUpdateDate: 03/04/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/04/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X3106CTN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X003106CTN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
2251H1200X003106CTN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
2251H1200X3106CTY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand

No ID Information.


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