Provider Demographics
NPI:1083792295
Name:CULLEN WEBER, EILEEN (PT)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:
Last Name:CULLEN WEBER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 SCORTON MARSH RD
Mailing Address - Street 2:
Mailing Address - City:EAST SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02537-1256
Mailing Address - Country:US
Mailing Address - Phone:508-833-2145
Mailing Address - Fax:
Practice Address - Street 1:1600 FALMOUTH RD
Practice Address - Street 2:UNIT 34
Practice Address - City:CENTERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02632-2939
Practice Address - Country:US
Practice Address - Phone:508-775-0060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0007341Medicare PIN