Provider Demographics
NPI:1609181460
Name:RAGEL, LAURA KATHRYN (DPT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:KATHRYN
Last Name:RAGEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 DERRY ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3576
Mailing Address - Country:US
Mailing Address - Phone:717-839-2110
Mailing Address - Fax:717-565-1934
Practice Address - Street 1:244 RTE 206
Practice Address - Street 2:SUITE 3
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9199
Practice Address - Country:US
Practice Address - Phone:973-598-3077
Practice Address - Fax:973-598-3097
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01360900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist