Provider Demographics
NPI:1093123358
Name:CARRERAS, MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:CARRERAS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1 CREDIT UNION WAY FL 3
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4633
Mailing Address - Country:US
Mailing Address - Phone:781-961-3370
Mailing Address - Fax:781-961-1291
Practice Address - Street 1:445 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-1900
Practice Address - Country:US
Practice Address - Phone:781-341-1942
Practice Address - Fax:781-436-8554
Is Sole Proprietor?:No
Enumeration Date:2014-07-30
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0115262251P0200X
MA19709225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics