Provider Demographics
NPI:1902190036
Name:GINSBURG, LAURYN (PT)
Entity Type:Individual
Prefix:
First Name:LAURYN
Middle Name:
Last Name:GINSBURG
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 1:535 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-5261
Mailing Address - Country:US
Mailing Address - Phone:781-961-3370
Mailing Address - Fax:781-767-7531
Practice Address - Street 1:254 ESSEX ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-1944
Practice Address - Country:US
Practice Address - Phone:978-338-5688
Practice Address - Fax:978-338-5685
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18752225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist