Individual
ELISABETH ANN PERUGINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1150 WYOMING AVE, SUITE 700, WYOMING, PA 18644-1366
(570) 288-1734
(570) 288-1735
Mailing address
1150 WYOMING AVE, SUITE 700, WYOMING, PA 18644-1366
(570) 288-1734
(570) 288-1735
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT016209
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014396950001
—
PA
05
—
1014396950002
—
PA
01
—
11510478
CAQH UNIVERSAL CREDENTIAL
PA
01
—
7510777
AETNA PROVIDER ID NUMBER
PA
Enumeration date
12/05/2006
Last updated
07/09/2007
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