Provider Demographics
NPI:1306316427
Name:LENTO, KERRI ANN (PTA)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:ANN
Last Name:LENTO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 SAINT MARYS WAY
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-1917
Mailing Address - Country:US
Mailing Address - Phone:617-921-8629
Mailing Address - Fax:
Practice Address - Street 1:204 PROCTOR AVE
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-4923
Practice Address - Country:US
Practice Address - Phone:781-286-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-01
Last Update Date:2018-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8222225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant