Individual provider Active NPI

Laura Gennarelli, MPT

  • Physical Therapist
  • Paoli, PA
National Provider Identifier
1902019375
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011383L Issued in PA
Practice address
2 Industrial Blvd Ste 200
Paoli, PA 19301-1645
Phone
(610) 648-1063
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
No

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
PT011383LPAMDPhysical Therapist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT011383L PA Primary

Addresses

NPPES NPI Registry

Primary practice location

2 Industrial Blvd Ste 200
Paoli, PA 19301-1645

Mailing address

105 Glenn Rd Unit 9
Ardmore, PA 19003-2524

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902019375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 GLENN RD UNIT 9",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190032524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 INDUSTRIAL BLVD STE 200",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011645",
            "telephone_number": "610-648-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENNARELLI",
        "first_name": "LAURA",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT011383L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.