Healthcare Provider Details

I. General information

NPI: 1932033503
Provider Name (Legal Business Name): LAUREN DREUSICKE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 WATER ST
BOSTON MA
02109-3503
US

IV. Provider business mailing address

4 RICHMOND SQ
PROVIDENCE RI
02906-5117
US

V. Phone/Fax

Practice location:
  • Phone: 857-277-0923
  • Fax: 844-912-8606
Mailing address:
  • Phone: 401-433-4172
  • Fax: 401-433-6012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL89811
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: