Provider Demographics
NPI:1154036473
Name:O'CONNELL, LAUREN ANNE (PT, DPT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ANNE
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 KAKEOUT RD
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-2548
Mailing Address - Country:US
Mailing Address - Phone:973-838-6252
Mailing Address - Fax:973-838-4159
Practice Address - Street 1:300 KAKEOUT RD
Practice Address - Street 2:
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-2548
Practice Address - Country:US
Practice Address - Phone:973-838-6252
Practice Address - Fax:973-838-4159
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA019072002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic