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Individual
MR. GUSTAV LUKE HENSEL
Active
Individual
MR. GUSTAV LUKE HENSEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSSM, ATC, SCC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
25MT00139700
NJ
2255A2300X
Athletic Trainer
Primary
RT005334
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080102002
NATIONAL ATHLETIC TRAINERS' ASSOCIATION CERTIFICATION NUMBER
—
01
—
25MT00139700
NEW JERSEY OFFICE OF THE ATTORNEY GENERAL DIVISION OF CONSUMER AFFAIRS
NJ
01
—
RT005334
PENNSYLVANIA STATE BOARD OF MEDICAL EXAMINERS
PA
Enumeration date
02/16/2006
Last updated
05/12/2020
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