Active NPI
Lauren R Canner, DPT
- Physical Therapist
- Plainview, NY
National Provider Identifier
1770824393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 031792-1
- Practice address
- 225 Executive Dr
Suite Ll108
Plainview, NY 11803-1718 - Phone
- (516) 576-2040
- Fax
- (516) 576-2131
- NPI assigned
- Mar 6, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 031792-1 | NY | Primary |
Addresses
Primary practice location
225 Executive Dr
Suite Ll108
Plainview, NY 11803-1718
Mailing address
2049 Brian Dr
North Merrick, NY 11566-1701
Phone (631) 786-4503
Other names 1
- Mrs. Lauren R Pasquarelli
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
| License | State | Type | Specialty |
|---|---|---|---|
| 031792-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362528000000",
"number": "1770824393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2049 BRIAN DR",
"city": "NORTH MERRICK",
"state": "NY",
"postal_code": "115661701",
"telephone_number": "631-786-4503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 EXECUTIVE DR",
"address_2": "SUITE LL108",
"city": "PLAINVIEW",
"state": "NY",
"postal_code": "118031718",
"telephone_number": "516-576-2040",
"fax_number": "516-576-2131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNER",
"first_name": "LAUREN",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-06",
"last_updated": "2013-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "031792-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LAUREN",
"last_name": "PASQUARELLI",
"middle_name": "R",
"prefix": "MRS.",
"credential": "DPT",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Plainview, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.