Provider Demographics
NPI:1992176317
Name:REED, LORIANN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:LORIANN
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:LORIANN
Other - Middle Name:
Other - Last Name:GIOVANNIELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:22 GREENLEAF DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3740
Mailing Address - Country:US
Mailing Address - Phone:732-861-7339
Mailing Address - Fax:
Practice Address - Street 1:130 S BRYN MAWR AVE
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010
Practice Address - Country:US
Practice Address - Phone:105-263-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC50001215363A00000X
VA0110-005120363AM0700X
PAMA059784363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical