Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lucille Renee Derose, PTA

Individual provider Physical Therapy Assistant · NPI 1912025826

Lucille Renee Derose, PTA is a Physical Therapy Assistant in Haverford, Pennsylvania. Practices as a sole proprietor. Licensed in New Jersey.

Licensed in
NJ
In the registry since
2007
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

551 W Lancaster Ave
Haverford, PA 19041-1419
Phone: (180) 055-0921
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 40QB00091900 (NJ)

Record details

NPI number1912025826
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorYes
NPI enumeratedMarch 27, 2007
Last updated in NPPESSeptember 10, 2008

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