Provider Demographics
NPI:1437296233
Name:PELUSO, LAUREN LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:LYNN
Last Name:PELUSO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 VENTANA DR
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-9431
Mailing Address - Country:US
Mailing Address - Phone:412-445-3674
Mailing Address - Fax:
Practice Address - Street 1:175 QUINN DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15275-1013
Practice Address - Country:US
Practice Address - Phone:412-788-1691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001751152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist