Provider Demographics
NPI:1740409010
Name:GILBERT, JENNIFER ROBIN (PT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ROBIN
Last Name:GILBERT
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 1:12 GODFREY ST # 3
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-4815
Mailing Address - Country:US
Mailing Address - Phone:508-880-2090
Mailing Address - Fax:
Practice Address - Street 1:389 ALDEN RD
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-4451
Practice Address - Country:US
Practice Address - Phone:508-991-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist