Healthcare Provider Details

I. General information

NPI: 1164648218
Provider Name (Legal Business Name): LOREE ANN BLOSZINSKY P.T.A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 HICKORY RD SUITE 240
PLYMOUTH MEETING PA
19462-1047
US

IV. Provider business mailing address

2378 BLACK RIVER RD
BETHLEHEM PA
18015-5402
US

V. Phone/Fax

Practice location:
  • Phone: 610-834-1122
  • Fax: 610-834-7525
Mailing address:
  • Phone: 610-882-2659
  • Fax: 610-317-0734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTE000054L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: