Provider Demographics
NPI:1720121387
Name:MACPHERSON, LORIAN (PT)
Entity Type:Individual
Prefix:
First Name:LORIAN
Middle Name:
Last Name:MACPHERSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LORIAN
Other - Middle Name:
Other - Last Name:DIBLASI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:47 UNDERHILL AVE
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-5019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:47 UNDERHILL AVE
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-5019
Practice Address - Country:US
Practice Address - Phone:516-637-3833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020272-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist