Provider Demographics
NPI:1528523933
Name:ALBRECHT, JAMIE P (MA, LAT, ATC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:P
Last Name:ALBRECHT
Suffix:
Gender:F
Credentials:MA, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 CENTRAL ST APT 2
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-2042
Mailing Address - Country:US
Mailing Address - Phone:518-929-5973
Mailing Address - Fax:
Practice Address - Street 1:161 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-5593
Practice Address - Country:US
Practice Address - Phone:617-627-5102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-10
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-38202255A2300X
MA34742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer