Provider Demographics
NPI:1770839763
Name:LAWRENCE A. PASTER PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:LAWRENCE A. PASTER PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:818-679-6797
Mailing Address - Street 1:2285 CROSS RD
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-5023
Mailing Address - Country:US
Mailing Address - Phone:215-887-2001
Mailing Address - Fax:215-887-8911
Practice Address - Street 1:2285 CROSS RD
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-5023
Practice Address - Country:US
Practice Address - Phone:215-887-2001
Practice Address - Fax:215-887-8911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty