1376736207 NPI number — MS. SMARAGTHE BARBARA STITT PHYSICAL THERAPIST

Table of content: MS. SMARAGTHE BARBARA STITT PHYSICAL THERAPIST (NPI 1376736207)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376736207 NPI number — MS. SMARAGTHE BARBARA STITT PHYSICAL THERAPIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STITT
Provider First Name:
SMARAGTHE
Provider Middle Name:
BARBARA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PHYSICAL THERAPIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STITT
Provider Other First Name:
MARGO
Provider Other Middle Name:
BARBARA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHYSICAL THERAPIST
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1376736207
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/23/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 BIRD HILL ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02421-6105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-439-8852
Provider Business Mailing Address Fax Number:
781-862-4787

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
164R MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WATERTOWN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02472-2695
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-439-8852
Provider Business Practice Location Address Fax Number:
781-862-4787
Provider Enumeration Date:
08/23/2007

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: 225100000X , with the licence number:  5557 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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