Provider Demographics
NPI:1740676832
Name:JENSEN, ADRIENNE (DPT)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:668 MARSHALL RD
Mailing Address - Street 2:APT 2F
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5328
Mailing Address - Country:US
Mailing Address - Phone:631-580-5200
Mailing Address - Fax:631-580-5222
Practice Address - Street 1:450 AMWELL RD
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1218
Practice Address - Country:US
Practice Address - Phone:908-359-3744
Practice Address - Fax:908-359-6761
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01605900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist