Provider Demographics
NPI:1093269599
Name:LIUZZA, NICHOLAS (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:LIUZZA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1595 BRIDGE ST
Mailing Address - Street 2:STE 5
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826
Mailing Address - Country:US
Mailing Address - Phone:508-208-3476
Mailing Address - Fax:
Practice Address - Street 1:1595 BRIDGE ST
Practice Address - Street 2:STE 5
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826
Practice Address - Country:US
Practice Address - Phone:508-208-3476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-12
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22494225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist