Provider Demographics
NPI:1629098421
Name:LEBEL, JEFFREY J (PT)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:J
Last Name:LEBEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 ELM ST
Mailing Address - Street 2:UNIT 7
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-3070
Mailing Address - Country:US
Mailing Address - Phone:207-571-3420
Mailing Address - Fax:207-571-3430
Practice Address - Street 1:380 ELM ST
Practice Address - Street 2:UNIT 7
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-3070
Practice Address - Country:US
Practice Address - Phone:207-571-3420
Practice Address - Fax:207-571-3430
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT1173225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME5983701OtherAETNA
ME1659181OtherCIGNA
ME080014243OtherRAILROAD MEDICARE
ME200244OtherANTHEM
ME253840099Medicaid
MEAA107652OtherHARVARD PILGRIM
MEME241001Medicare PIN