Provider Demographics
NPI:1043620974
Name:ABERNETHY, LAUREN M (DPT)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:M
Last Name:ABERNETHY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2127 RHAWN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-3216
Mailing Address - Country:US
Mailing Address - Phone:215-742-8099
Mailing Address - Fax:215-742-1871
Practice Address - Street 1:2127 RHAWN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-3216
Practice Address - Country:US
Practice Address - Phone:215-742-8099
Practice Address - Fax:215-742-1871
Is Sole Proprietor?:No
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022169225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist