Individual provider Active NPI

Lauren Alisson O'Donohue, PTA

  • Physical Therapy Assistant
  • Milford, PA
National Provider Identifier
1295989713
Registry record updated Nov 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TE008228 Issued in PA
Practice address
404 E Harford St
Milford, PA 18337-1028
Phone
(570) 409-9191
NPI assigned
Nov 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TE008228 PA Primary
Physical Therapy Assistant 225200000X 006073-1 NY

Addresses

Primary practice location

404 E Harford St
Milford, PA 18337-1028

Mailing address

PO Box 1122
Wurtsboro, NY 12790-1122
Phone (845) 888-4409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
006073-1NYMDPhysical Therapy Assistant
TE008228PAMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226361600000",
    "number": "1295989713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1122",
            "city": "WURTSBORO",
            "state": "NY",
            "postal_code": "127901122",
            "telephone_number": "845-888-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 E HARFORD ST",
            "city": "MILFORD",
            "state": "PA",
            "postal_code": "183371028",
            "telephone_number": "570-409-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONOHUE",
        "first_name": "LAUREN",
        "middle_name": "ALISSON",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-11",
        "last_updated": "2008-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE008228",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "006073-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.