MEDICARE: LISA HENNEN PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251P0200X	Pediatric Physical Therapist

General Provider Information

NPI Number	:	1205182433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA HENNEN PT, DPT

Provider Business Mailing Address
First Line	:	339 FOX CHAPEL RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15238-2329
Country	:	US
Telephone Number	:	412-877-0831
Fax Number	:

Provider Business Practice Location Address
First Line	:	339 FOX CHAPEL RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15238-2329
Country	:	US
Telephone Number	:	412-877-0831
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2012
Last Update Date	:	05/01/2025

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