Provider Demographics
NPI:1033287339
Name:CUMMINGS PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:CUMMINGS PHYSICAL THERAPY, INC
Other - Org Name:CUMMINGS PHYSICAL THERAPY , INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:617-846-0832
Mailing Address - Street 1:11 BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:MA
Mailing Address - Zip Code:02152-2912
Mailing Address - Country:US
Mailing Address - Phone:617-846-0832
Mailing Address - Fax:
Practice Address - Street 1:11 BARTLETT RD
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:MA
Practice Address - Zip Code:02152-2912
Practice Address - Country:US
Practice Address - Phone:617-846-0832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4442261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY68012Medicare UPIN