Provider Demographics
NPI:1487083853
Name:TRIPODI, LAUREN
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:TRIPODI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 MADISON ST
Mailing Address - Street 2:APT 7
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-1890
Mailing Address - Country:US
Mailing Address - Phone:848-218-1817
Mailing Address - Fax:
Practice Address - Street 1:80 MADISON ST
Practice Address - Street 2:APT 7
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-1890
Practice Address - Country:US
Practice Address - Phone:848-218-1817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00483200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist