Provider Demographics
NPI:1093231656
Name:HAFFEMANN, JEFFREY (PT, DPT)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:HAFFEMANN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 PRINCETON STREET
Mailing Address - Street 2:SUITE 8
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863
Mailing Address - Country:US
Mailing Address - Phone:978-710-7204
Mailing Address - Fax:978-710-5764
Practice Address - Street 1:73 PRINCETON STREET
Practice Address - Street 2:SUITE 8
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863
Practice Address - Country:US
Practice Address - Phone:978-710-7204
Practice Address - Fax:978-710-5764
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-16
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT32651225100000X
MA25348225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist