Provider Demographics
NPI:1073935763
Name:ROBERTA DECOUDRES SINGER
Entity Type:Organization
Organization Name:ROBERTA DECOUDRES SINGER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:DECOUDRES
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:847-732-8601
Mailing Address - Street 1:5 POND ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-3915
Mailing Address - Country:US
Mailing Address - Phone:847-732-8601
Mailing Address - Fax:
Practice Address - Street 1:5 POND ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3915
Practice Address - Country:US
Practice Address - Phone:847-732-8601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19288251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health