Healthcare Provider Details

I. General information

NPI: 1245518158
Provider Name (Legal Business Name): TIFFANY PALENSCAR PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TIFFANY CSIK

II. Dates (important events)

Enumeration Date: 07/26/2011
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 PINE ST
BRIDGEWATER MA
02324-2112
US

IV. Provider business mailing address

18 CHESTNUT ST STE 200
WORCESTER MA
01608-1557
US

V. Phone/Fax

Practice location:
  • Phone: 617-737-6658
  • Fax: 508-751-6346
Mailing address:
  • Phone: 617-304-6372
  • Fax: 508-751-6346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number19598
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: