MEDICARE: DR. LAUREN LYNN PELUSO O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OEG001751	PA

General Provider Information

NPI Number	:	1437296233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN LYNN PELUSO O.D.

Provider Business Mailing Address
First Line	:	2117 VENTANA DR
Second Line	:
City	:	CORAOPOLIS
State	:	PA
Zip	:	15108-9431
Country	:	US
Telephone Number	:	412-445-3674
Fax Number	:

Provider Business Practice Location Address
First Line	:	175 QUINN DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15275-1013
Country	:	US
Telephone Number	:	412-788-1691
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	07/08/2007

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