| Ms Lauren M Detullio, OT | |
|
950 Pulaski Dr Ste 100, King Of Prussia, PA 19406-2802 | |
| (610) 768-4460 | |
| (610) 768-5947 |
| Full Name | Ms Lauren M Detullio |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist - Hand |
| Location | 950 Pulaski Dr Ste 100, King Of Prussia, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689741050 | NPI | - | NPPES |
| 2184913000 | Other | PA | IBC - KEYSTONE |
| 1495761 | Other | PA | IBC - PERSONAL CHOICE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | OC008942 (Pennsylvania) | Secondary |
| 225XH1200X | Occupational Therapist - Hand | OC008942 (Pennsylvania) | Primary |
| Provider Name | Premier Orthopaedic And Sports Medicine Associates, Ltd |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1215987243 PECOS PAC ID: 5890681092 Enrollment ID: O20040225000221 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Lauren M Detullio, OT 950 Pulaski Dr Ste 100, King Of Prussia, PA 19406-2802 Ph: (484) 685-4801 | Ms Lauren M Detullio, OT 950 Pulaski Dr Ste 100, King Of Prussia, PA 19406-2802 Ph: (610) 768-4460 |
Rachel Elizabeth Brownback, MS,OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 600 W Valley Forge Rd, King Of Prussia, PA 19406 Phone: 610-337-1775 | |
Meredith Lee Kurth, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 600 W Valley Forge Rd, King Of Prussia, PA 19406 Phone: 610-337-1775 | |
Kristen Straube, OT Occupational Therapist Medicare: Medicare Enrolled Practice Location: 234 Mall Blvd Ste G50, King Of Prussia, PA 19406 Phone: 866-573-2556 | |
Maribeth Keith, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 339 Covered Bridge Rd, King Of Prussia, PA 19406 Phone: 484-881-2432 | |
Devon Rae Denman, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 610 Freedom Business Ctr Dr Ste 100, King Of Prussia, PA 19406 Phone: 484-224-7913 Fax: 484-224-7914 | |
Jennifer Hotaling, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 700 S Henderson Rd, Suite 200, King Of Prussia, PA 19406 Phone: 610-768-5940 Fax: 610-768-5947 | |
Gem Tiara Corpin Dadizon, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 931 Penn Cir Apt B207, King Of Prussia, PA 19406 Phone: 484-408-2202 |