MEDICARE: EUGENE R LAMBERT PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1388	MA

General Provider Information

NPI Number	:	1023007291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUGENE R LAMBERT PT

Provider Business Mailing Address
First Line	:	67 MILLBROOK ST
Second Line	:	SUITE 211
City	:	WORCESTER
State	:	MA
Zip	:	01606-2835
Country	:	US
Telephone Number	:	508-792-9955
Fax Number	:	508-792-9943

Provider Business Practice Location Address
First Line	:	67 MILLBROOK ST
Second Line	:	SUITE 211
City	:	WORCESTER
State	:	MA
Zip	:	01606-2835
Country	:	US
Telephone Number	:	508-792-9955
Fax Number	:	508-792-9943

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	06/16/2008

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