Provider Demographics
NPI:1164965729
Name:PINGUELO, LORNA
Entity Type:Individual
Prefix:
First Name:LORNA
Middle Name:
Last Name:PINGUELO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LORNA
Other - Middle Name:
Other - Last Name:TORRES-RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2545 SCHOENERSVILLE RD
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7300
Practice Address - Country:US
Practice Address - Phone:484-884-3333
Practice Address - Fax:484-884-3366
Is Sole Proprietor?:No
Enumeration Date:2016-11-29
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016784363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics