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General NPI Number Information
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NPI Number | 1225165707
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Entity Type | Individual
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Provider Name | JENNA M CHERENZIA ATC
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Gender | Female
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 145 MAIN ST UNIVERSITY OF NEW HAMPSHIRE
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City | DURHAM
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State | NH
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Zip | 03824-3572
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Country | US
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Telephone | 603-862-4987
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Fax |
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Provider Business Mailing Address
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Address Line | 40 KUEHN RD PO BOX 23
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City | HOPKINTON
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State | RI
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Zip | 02833
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Country | US
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Telephone | 401-742-5238
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0336
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License Number State | NH
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