Individual
LORI A DEPERSIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1648 HUNTINGDON PIKE, RADIOLOGY DEPARTMENT, MEADOWBROOK, PA 19046-8001
(215) 938-3467
(215) 938-3474
Mailing address
1001 BRIGGS RD, SUITE 210, MOUNT LAUREL, NJ 08054-4100
(856) 231-4774
(856) 231-9699
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
MD029084E
PA
2085R0202X
Diagnostic Radiology Physician
Primary
MD029084E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007325269
—
PA
05
—
0073256900006
—
PA
05
—
2210703
—
NJ
Enumeration date
08/16/2005
Last updated
06/18/2012
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