Provider Demographics
NPI:1003095894
Name:CALCAGNI, LAUREN D (PT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:D
Last Name:CALCAGNI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 BOSTON NECK RD STE 2
Mailing Address - Street 2:
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882-2926
Mailing Address - Country:US
Mailing Address - Phone:401-363-0333
Mailing Address - Fax:401-363-0363
Practice Address - Street 1:750 BOSTON NECK RD STE 2
Practice Address - Street 2:
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882-2926
Practice Address - Country:US
Practice Address - Phone:401-363-0333
Practice Address - Fax:401-363-0363
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01302100225100000X
HI2826225100000X
NY028740225100000X
RI02678225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
103171Medicare PIN