Healthcare Provider Details

I. General information

NPI: 1194792176
Provider Name (Legal Business Name): JENNIFER LENKAUSKAS P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 10/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 E MAIN ST
WESTBOROUGH MA
01581-1768
US

IV. Provider business mailing address

319A SOUTHBRIDGE STREET
AUBURN MA
01501-2568
US

V. Phone/Fax

Practice location:
  • Phone: 508-366-7899
  • Fax: 508-366-9819
Mailing address:
  • Phone: 508-832-2628
  • Fax: 508-832-7824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11934
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: