Provider Demographics
NPI:1720230394
Name:PENSKI-ADAMS, JENNIFER L (MSPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:PENSKI-ADAMS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:PENSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:1825 WINDFALL RD
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-9333
Mailing Address - Country:US
Mailing Address - Phone:716-375-8093
Mailing Address - Fax:
Practice Address - Street 1:1825 WINDFALL RD
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-9333
Practice Address - Country:US
Practice Address - Phone:716-375-8093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022038-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist