Provider Demographics
NPI:1164103305
Name:NEW ENGLAND PELVIC HEALTH AND REHAB PLLC
Entity Type:Organization
Organization Name:NEW ENGLAND PELVIC HEALTH AND REHAB PLLC
Other - Org Name:PELVIC HARMONY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEBRA
Authorized Official - Suffix:
Authorized Official - Credentials:OTD
Authorized Official - Phone:207-463-6361
Mailing Address - Street 1:366 METCALF DR
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-8809
Mailing Address - Country:US
Mailing Address - Phone:207-463-6361
Mailing Address - Fax:
Practice Address - Street 1:366 METCALF DR
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-8809
Practice Address - Country:US
Practice Address - Phone:207-463-6361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty