Provider Demographics
NPI:1841317559
Name:LUCIANI, JUANITA TORRES (PTA)
Entity type:Individual
Prefix:MRS
First Name:JUANITA
Middle Name:TORRES
Last Name:LUCIANI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:JUANITA
Other - Middle Name:
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:3241 CARROLL CT
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-1816
Mailing Address - Country:US
Mailing Address - Phone:215-750-1979
Mailing Address - Fax:
Practice Address - Street 1:300 E WINCHESTER AVE
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-2250
Practice Address - Country:US
Practice Address - Phone:215-757-3739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE001833L225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant