Provider Demographics
NPI:1568916047
Name:MOLL, LAUREN CHRISTINE (DPT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:CHRISTINE
Last Name:MOLL
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 392573
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-9573
Mailing Address - Country:US
Mailing Address - Phone:724-343-4060
Mailing Address - Fax:724-343-4069
Practice Address - Street 1:207 W 4TH ST STE A
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:PA
Practice Address - Zip Code:19405-1061
Practice Address - Country:US
Practice Address - Phone:610-228-4641
Practice Address - Fax:570-874-3283
Is Sole Proprietor?:No
Enumeration Date:2016-08-12
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025330225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396749Medicare PIN