Provider Demographics
NPI:1114104312
Name:BANFFY, EMILY M (MSPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:BANFFY
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WALNUT ST # 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7748
Mailing Address - Country:US
Mailing Address - Phone:617-734-0340
Mailing Address - Fax:
Practice Address - Street 1:1237 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2615
Practice Address - Country:US
Practice Address - Phone:781-444-1290
Practice Address - Fax:866-305-1388
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18119225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist