Provider Demographics
NPI:1447086509
Name:LENKIEWICZ, BRANDON
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:LENKIEWICZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 WET SAND DR
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-2819
Mailing Address - Country:US
Mailing Address - Phone:410-206-7380
Mailing Address - Fax:
Practice Address - Street 1:510 WET SAND DR
Practice Address - Street 2:
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144-2819
Practice Address - Country:US
Practice Address - Phone:410-206-7380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist