Provider Demographics
NPI:1376200154
Name:LERRO, KRISTIN (PTA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:LERRO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 RIVERWATCH CT
Mailing Address - Street 2:
Mailing Address - City:BLAWNOX
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2762
Mailing Address - Country:US
Mailing Address - Phone:412-443-8951
Mailing Address - Fax:
Practice Address - Street 1:5738 FORBES AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1563
Practice Address - Country:US
Practice Address - Phone:412-443-8951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI003087225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant