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General NPI Number Information
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NPI Number | 1699753327
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Entity Type | Individual
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Provider Name | LORELEI L RAYMUNDO M.S.P.T., PA
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Gender | Female
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Dates
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Enumeration Date | 01/04/2006
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 30 LOCUST ST
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City | NORTHAMPTON
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State | MA
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Zip | 01060-2052
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Country | US
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Telephone | 413-582-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 73 BARRETT ST APT 2095
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City | NORTHAMPTON
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State | MA
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Zip | 01060-1734
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Country | US
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Telephone | 480-639-9305
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3677
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA4915
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License Number State | MA
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