1528133485 NPI number — MS. CATHERINE MAY O KEEFFE MSPT

Table of content: MS. CATHERINE MAY O KEEFFE MSPT (NPI 1528133485)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528133485 NPI number — MS. CATHERINE MAY O KEEFFE MSPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O KEEFFE
Provider First Name:
CATHERINE
Provider Middle Name:
MAY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSPT
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:
1528133485
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
825 WASHINGTON ST
Provider Second Line Business Mailing Address:
STE 280 PHYSICAL THERAPY & SPORTS REHAB INC
Provider Business Mailing Address City Name:
NORWOOD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02062
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-769-2040
Provider Business Mailing Address Fax Number:
781-769-1914

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
227 DEDHAM ST
Provider Second Line Business Practice Location Address:
PHYSICAL THERAPY & SPORTS REHAB INC
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02056
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-384-7020
Provider Business Practice Location Address Fax Number:
508-384-7025
Provider Enumeration Date:
11/22/2006

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:  9364 , 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)

  • Identifier: Y68509 . This is a "BC BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 797660 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".