1114119112 NPI number — MRS. PATRICIA MARIE PAURIS M.S., A.T.C., CPT

Table of content: MRS. PATRICIA MARIE PAURIS M.S., A.T.C., CPT (NPI 1114119112)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114119112 NPI number — MRS. PATRICIA MARIE PAURIS M.S., A.T.C., CPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAURIS
Provider First Name:
PATRICIA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., A.T.C., CPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114119112
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
115 LINCOLN ST
Provider Second Line Business Mailing Address:
OUTPATIENT PHYSICAL THERAPY
Provider Business Mailing Address City Name:
FRAMINGHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01702-6358
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-383-1070
Provider Business Mailing Address Fax Number:
508-383-1075

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
529 PROVIDENCE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DEDHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02026-6807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
774-360-1900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2255A2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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