Individual
LAUREN THERIAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3855 W CHESTER PIKE STE 300, NEWTOWN SQUARE, PA 19073-2304
(484) 427-8000
Mailing address
3803 W CHESTER PIKE STE 160, NEWTOWN SQUARE, PA 19073-2336
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
042.0014063
VT
207R00000X
Internal Medicine Physician
Primary
MD473554
PA
Other
Enumeration date
03/24/2015
Last updated
10/16/2024
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