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General NPI Number Information
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NPI Number | 1871219568
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Entity Type | Individual
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Provider Name | LAUREN EILEEN PERUSO
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Gender | Female
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 10/14/2022
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Provider Practice Location Address
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Address Line | 704 W NIELDS ST STE 4-5
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City | WEST CHESTER
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State | PA
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Zip | 19382-4102
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Country | US
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Telephone | 610-431-2008
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Fax |
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Provider Business Mailing Address
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Address Line | 7715 LAWNTON ST
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City | PHILADELPHIA
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State | PA
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Zip | 19128-3105
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Country | US
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Telephone | 845-325-4727
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AK0011365
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License Number State | PA
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