Provider Demographics
NPI:1023007291
Name:LAMBERT, EUGENE R (PT)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:R
Last Name:LAMBERT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 MILLBROOK ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2835
Mailing Address - Country:US
Mailing Address - Phone:508-792-9955
Mailing Address - Fax:508-792-9943
Practice Address - Street 1:67 MILLBROOK ST
Practice Address - Street 2:SUITE 211
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-2835
Practice Address - Country:US
Practice Address - Phone:508-792-9955
Practice Address - Fax:508-792-9943
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-19
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1388225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY65007Medicare PIN