Provider Demographics
NPI:1982896718
Name:LORD, AISHA (MSPT DPT)
Entity type:Individual
Prefix:DR
First Name:AISHA
Middle Name:
Last Name:LORD
Suffix:
Gender:F
Credentials:MSPT DPT
Other - Prefix:DR
Other - First Name:AISHA
Other - Middle Name:
Other - Last Name:LORD RYAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSPT,DPT
Mailing Address - Street 1:PO BOX 856
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-0856
Mailing Address - Country:US
Mailing Address - Phone:302-376-5578
Mailing Address - Fax:302-376-5580
Practice Address - Street 1:212 CARTER DR STE C
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709
Practice Address - Country:US
Practice Address - Phone:302-376-5578
Practice Address - Fax:302-376-5580
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1000-25532251X0800X
DC870527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG02248A01Medicare PIN
DCQ64451Medicare UPIN