Provider Demographics
NPI:1154857852
Name:WYROSTEK, LAUREN (CP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:WYROSTEK
Suffix:
Gender:F
Credentials:CP
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:SLAMPAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 ALPHA DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2908
Mailing Address - Country:US
Mailing Address - Phone:412-599-1105
Mailing Address - Fax:412-599-1155
Practice Address - Street 1:200 CEDAR RIDGE DR
Practice Address - Street 2:#205
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-9691
Practice Address - Country:US
Practice Address - Phone:412-599-1105
Practice Address - Fax:412-599-1155
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPO000064224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist