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NPI Code Detail

MEDICARE: LAUREN M IRIZARRY PT, DPT

MEDICARE: LAUREN M IRIZARRY PT, DPT
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
1225100000XPhysical Therapist40QA01678000NJ

General Provider Information

NPI Number : 1588119796
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN M IRIZARRY PT, DPT
Provider Business Mailing Address
First Line : PO BOX 1014
Second Line :
City : CLARK
State : NJ
Zip : 07066-1014
Country : US
Telephone Number : 732-855-9751
Fax Number : 732-855-9755
Provider Business Practice Location Address
First Line : 3276 WASHINGTON RD
Second Line :
City : PARLIN
State : NJ
Zip : 08859-1676
Country : US
Telephone Number : 732-238-8484
Fax Number : 732-855-9755
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2016
Last Update Date : 02/17/2020

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