Provider Demographics
NPI:1649638818
Name:BLANCHETTE, LAUREEN MARY (PT, DPT)
Entity type:Individual
Prefix:
First Name:LAUREEN
Middle Name:MARY
Last Name:BLANCHETTE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:LAUREEN
Other - Middle Name:MARY
Other - Last Name:REGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:106 EQUESTRIAN DR
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:PA
Mailing Address - Zip Code:18938-5800
Mailing Address - Country:US
Mailing Address - Phone:215-932-9559
Mailing Address - Fax:
Practice Address - Street 1:1660 EASTON RD
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-1202
Practice Address - Country:US
Practice Address - Phone:215-932-9559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020311225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist