Provider Demographics
NPI:1720016892
Name:KLESZCZYNSKI, RENEE CARRIE (ATC)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:CARRIE
Last Name:KLESZCZYNSKI
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF NEW HAMPSHIRE
Mailing Address - Street 2:145 MAIN STREET
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824
Mailing Address - Country:US
Mailing Address - Phone:603-862-3892
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF NEW HAMPSHIRE
Practice Address - Street 2:145 MAIN STREET
Practice Address - City:DURHAM
Practice Address - State:NH
Practice Address - Zip Code:03824
Practice Address - Country:US
Practice Address - Phone:603-862-3892
Practice Address - Fax:603-862-4198
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2255A2300X
NH03442255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer