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General NPI Number Information
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NPI Number | 1174095418
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Entity Type | Individual
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Provider Name | LAUREN BERTI PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 12/27/2018
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Last Update Date | 12/27/2018
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Provider Practice Location Address
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Address Line | 710 OBRECHT RD
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City | SYKESVILLE
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State | MD
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Zip | 21784-7650
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Country | US
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Telephone | 107-958-8084
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Fax |
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Provider Business Mailing Address
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Address Line | 6307 PITCH PINE CT
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City | SYKESVILLE
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State | MD
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Zip | 21784-4923
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Country | US
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Telephone | 410-294-9843
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0301X
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Taxonomy Name | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 24256
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License Number State | MD
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