Provider Demographics
NPI:1124340971
Name:GALLUCCI, LAUREN R (DPT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:R
Last Name:GALLUCCI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:M
Other - Last Name:ROMESTAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:418 UPPER RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1041
Mailing Address - Country:US
Mailing Address - Phone:412-952-8678
Mailing Address - Fax:
Practice Address - Street 1:418 UPPER RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1041
Practice Address - Country:US
Practice Address - Phone:412-952-8678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019965225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist