Provider Demographics
NPI:1881922359
Name:BOKUNIEWICZ, LINDSEY DAWN (DPT)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:DAWN
Last Name:BOKUNIEWICZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:LINDSEY
Other - Middle Name:DAWN
Other - Last Name:PICCIRILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:58 RANGE RD
Mailing Address - Street 2:SUITE 16
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-2026
Mailing Address - Country:US
Mailing Address - Phone:603-890-8844
Mailing Address - Fax:603-890-8845
Practice Address - Street 1:58 RANGE RD
Practice Address - Street 2:SUITE 16
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-2026
Practice Address - Country:US
Practice Address - Phone:603-890-8844
Practice Address - Fax:603-890-8845
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-21
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3495225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1881922359Medicaid