Provider Demographics
NPI:1699776872
Name:DINGES, LORI S (PT)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:S
Last Name:DINGES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-8844
Mailing Address - Country:US
Mailing Address - Phone:570-748-2678
Mailing Address - Fax:570-748-4015
Practice Address - Street 1:685 ISLAND RD
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-8844
Practice Address - Country:US
Practice Address - Phone:570-748-2678
Practice Address - Fax:570-748-2678
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009179L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA814290OtherFIRST PRIORITY
PA927262OtherBC/BS
PA149529OtherHEALTH AMERICA-IND.
PA001878807Medicaid
PA814290OtherFIRST PRIORITY