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NPI Code Detail

MEDICARE: LORI DECK

MEDICARE:   LORI  DECK
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
1224Z00000XOccupational Therapy AssistantOP003782PA

General Provider Information

NPI Number : 1831506104
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI DECK
Provider Business Mailing Address
First Line : 10 LAWNSIDE RD
Second Line :
City : CHELTENHAM
State : PA
Zip : 19012-1813
Country : US
Telephone Number : 215-745-8679
Fax Number :
Provider Business Practice Location Address
First Line : 8015 LAWNDALE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19111-1507
Country : US
Telephone Number : 215-745-8679
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2014
Last Update Date : 07/17/2014

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Directions to “ LORI DECK ” Practice Location

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