Provider Demographics
NPI:1144468539
Name:SEMBRANO, KIMBERLEY DANIELLE (MSPT)
Entity type:Individual
Prefix:MS
First Name:KIMBERLEY
Middle Name:DANIELLE
Last Name:SEMBRANO
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:KIMBERLEY
Other - Middle Name:DANIELLE
Other - Last Name:MAUGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 UNICORN PARK DR
Mailing Address - Street 2:STE 201
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-3342
Mailing Address - Country:US
Mailing Address - Phone:781-782-1300
Mailing Address - Fax:781-782-1350
Practice Address - Street 1:30 LANCASTER ST STE 100
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-1704
Practice Address - Country:US
Practice Address - Phone:617-367-4700
Practice Address - Fax:617-367-4701
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT008464225100000X
MA19791225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist