Provider Demographics
NPI:1174095418
Name:BERTI, LAUREN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:BERTI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6307 PITCH PINE CT
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-4923
Mailing Address - Country:US
Mailing Address - Phone:410-294-9843
Mailing Address - Fax:
Practice Address - Street 1:710 OBRECHT RD
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-7650
Practice Address - Country:US
Practice Address - Phone:107-958-8084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD242562081P0301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0301XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationBrain Injury Medicine