Provider Demographics
NPI:1366440158
Name:LUPIN, LESLIE ANNE (PT)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANNE
Last Name:LUPIN
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 1:2775 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7307
Mailing Address - Country:US
Mailing Address - Phone:610-861-8080
Mailing Address - Fax:610-807-0366
Practice Address - Street 1:2775 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7307
Practice Address - Country:US
Practice Address - Phone:610-861-8080
Practice Address - Fax:610-807-0366
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002289E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2170561OtherMAMSI
02004601OtherCAPITAL BLUE CROSS
0556421OtherAETNA PPO
0482839000OtherINDEPENDENCE BLUE CROSS
651642OtherHIGHMARK BLUE SHIELD
2121856OtherUNITED HEALTHCARE
817950OtherFIRST PRIORITY HEALTH
02004601OtherKEYSTONE HEALTH CENTRAL
0482839000OtherKEYSTONE HEALTH EAST
3539544OtherCIGNA HEALTHCARE
47241OtherGEISINGER HEALTH PLAN
P1643783OtherOXFORD HEALTH PLANS
0482839000OtherAMERIHEALTH
329116OtherHEALTHAMERICA/HEALTHASSUR
47241OtherGEISINGER HEALTH PLAN