Provider Demographics
NPI:1689428492
Name:VASATURO, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:VASATURO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 CAMWAY DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-3415
Mailing Address - Country:US
Mailing Address - Phone:571-606-2347
Mailing Address - Fax:
Practice Address - Street 1:545 CAMWAY DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-3415
Practice Address - Country:US
Practice Address - Phone:571-606-2347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home