Provider Demographics
NPI:1114017514
Name:EHRENKRANZ, CHERYL E (PT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:E
Last Name:EHRENKRANZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 MOUNT AUBURN ST
Mailing Address - Street 2:STE 205
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-4153
Mailing Address - Country:US
Mailing Address - Phone:617-923-0757
Mailing Address - Fax:617-923-2127
Practice Address - Street 1:521 MOUNT AUBURN ST
Practice Address - Street 2:SUITE 205
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4191
Practice Address - Country:US
Practice Address - Phone:617-923-0757
Practice Address - Fax:617-923-2127
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1812225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY66538OtherBC/BS
MAY68226Medicare ID - Type Unspecified