Provider Demographics
NPI:1033260070
Name:ROADARMEL, LAURA E (MSOTRL)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:ROADARMEL
Suffix:
Gender:F
Credentials:MSOTRL
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:E
Other - Last Name:NORK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOTRL
Mailing Address - Street 1:306 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-1551
Mailing Address - Country:US
Mailing Address - Phone:570-594-1068
Mailing Address - Fax:
Practice Address - Street 1:1751 E BROAD ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-5650
Practice Address - Country:US
Practice Address - Phone:570-501-9814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010065225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2483752OtherAETNA
PA001963462OtherHIGHMARK BLUE SHIELD
PA50066692OtherCAPITAL BLUE CROSS
PA2483752OtherAETNA