Jenna L Bensen, LMT
Individual provider Active NPI Massage Therapist · Latham, NY
NPI 1053564906 · NPPES record last updated Oct 23, 2008
Key facts
- NPI
- 1053564906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 020905-1 (NY)
- Practice address
- 578 New Loudon Rd
Latham, NY 12110-4038 - Phone
- (518) 389-2200
- Fax
- (518) 389-2083
- NPI assigned
- Oct 23, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020905-1 | NY | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 020905-1 | NY | Yes |
Addresses
Primary practice location
578 New Loudon Rd
Latham, NY 12110-4038
Mailing address
578 New Loudon Rd
Latham, NY 12110-4038
Phone (518) 389-2200
Other providers in Latham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.