Healthcare Provider Details

I. General information

NPI: 1093886814
Provider Name (Legal Business Name): LINA PENIKAS LAMB P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINA MARIA PENIKAS P.T.

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 01/19/2021
Certification Date: 01/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 POND PARK RD
HINGHAM MA
02043-4347
US

IV. Provider business mailing address

143 LONGWATER DR
NORWELL MA
02061-1683
US

V. Phone/Fax

Practice location:
  • Phone: 781-624-2542
  • Fax: 781-741-6219
Mailing address:
  • Phone: 781-878-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number16663
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number16663
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: