Provider Demographics
NPI:1134915713
Name:TREMBLAY, ALEX JAYNA (LMT)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:JAYNA
Last Name:TREMBLAY
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 NORTH ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:WARE
Mailing Address - State:MA
Mailing Address - Zip Code:01082-1199
Mailing Address - Country:US
Mailing Address - Phone:508-826-4200
Mailing Address - Fax:
Practice Address - Street 1:79 NORTH ST APT 2R
Practice Address - Street 2:
Practice Address - City:WARE
Practice Address - State:MA
Practice Address - Zip Code:01082-1199
Practice Address - Country:US
Practice Address - Phone:508-826-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5888225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist