Basic Information
| Provider Information | |||||||||
| NPI: | 1700893401 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LENCESKI | ||||||||
| FirstName: | RENEE | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 MICHELINE DR | ||||||||
| Address2: | |||||||||
| City: | OLD FORGE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 185182359 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704570884 | ||||||||
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| Practice Location | |||||||||
| Address1: | 501 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | OLD FORGE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704574099 | ||||||||
| FaxNumber: | 5704577205 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT016563 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 1786782 | 01 | HIGHMARK BLUE SHIELD | OTHER | 9412543 | 01 | CIGNA | OTHER | 819843 | 01 | FIRST PRIORITY HEALTH | OTHER | 416843 | 01 | HEALTH AMERICA | OTHER |