Healthcare Provider Details

I. General information

NPI: 1306392014
Provider Name (Legal Business Name): LORRAINE S CAPRIOLI MPT, CEEAA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 09/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 SENTRY PRK WEST
BLUE BELL PA
19422
US

IV. Provider business mailing address

1145 W CAMPBELL RD
GREEN LANE PA
18054-2106
US

V. Phone/Fax

Practice location:
  • Phone: 610-277-1100
  • Fax: 215-646-1900
Mailing address:
  • Phone: 610-277-1100
  • Fax: 215-646-1900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT016413
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: