Provider Demographics
NPI:1568422491
Name:THE LYMPHEDEMA CONNECTION
Entity Type:Organization
Organization Name:THE LYMPHEDEMA CONNECTION
Other - Org Name:THE LYMPHEDEMA CONNECTION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:412-364-3720
Mailing Address - Street 1:8400 PERRY HWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5235
Mailing Address - Country:US
Mailing Address - Phone:412-364-3720
Mailing Address - Fax:
Practice Address - Street 1:8400 PERRY HWY
Practice Address - Street 2:SUITE 204
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5235
Practice Address - Country:US
Practice Address - Phone:412-364-3720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000005680332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA71668OtherHEALTH AMERICA
PA1462651OtherBLUE CROSS BLUE SHIELD
PA320888OtherUPMC
PA1462651OtherBLUE CROSS BLUE SHIELD