Provider Demographics
NPI:1396035895
Name:LENAHAN, ROBERT F (DAC,CA)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:LENAHAN
Suffix:
Gender:M
Credentials:DAC,CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-2045
Mailing Address - Country:US
Mailing Address - Phone:732-899-0951
Mailing Address - Fax:732-899-0951
Practice Address - Street 1:3402 RIVER RD
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-2045
Practice Address - Country:US
Practice Address - Phone:732-899-0951
Practice Address - Fax:732-899-0951
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00000100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MZ00000100OtherACUPUNCTURE LICENSE NUMBER