Provider Demographics
NPI:1104031772
Name:ACKROYD, DENA LEPRE (PA- C)
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:LEPRE
Last Name:ACKROYD
Suffix:
Gender:
Credentials:PA- C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:362 MOUNT VERNON ST
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-3327
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1150 RESERVOIR AVE STE 201
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6032
Practice Address - Country:US
Practice Address - Phone:401-942-1300
Practice Address - Fax:617-224-1007
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2025-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIPA00743363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant