Healthcare Provider Details

I. General information

NPI: 1073555447
Provider Name (Legal Business Name): LAURA TRIBOLET GIULIANI P.T. M.S.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 EASTON RD
ROSLYN PA
19001-2401
US

IV. Provider business mailing address

109 KENT DR
NORTH WALES PA
19454-1926
US

V. Phone/Fax

Practice location:
  • Phone: 215-885-2022
  • Fax: 215-885-7408
Mailing address:
  • Phone: 215-661-8446
  • Fax: 215-661-8426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT007966L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: