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NPI Code Detail

MEDICARE: MS. LAUREN ELIZABETH DESROCHES PA

MEDICARE: MS. LAUREN ELIZABETH DESROCHES PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician0110006844VA
2363A00000XPhysician Assistant

General Provider Information

NPI Number : 1881241305
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LAUREN ELIZABETH DESROCHES PA
Provider Business Mailing Address
First Line : PO BOX 780125
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19178-0125
Country : US
Telephone Number : 804-922-4844
Fax Number :
Provider Business Practice Location Address
First Line : 7101 JAHNKE RD # 205
Second Line :
City : RICHMOND
State : VA
Zip : 23225-4017
Country : US
Telephone Number : 757-716-3742
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2019
Last Update Date : 12/10/2025

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