Provider Demographics
NPI:1235851379
Name:ANDREA SCHLEIBAUM DPT, PLLC
Entity Type:Organization
Organization Name:ANDREA SCHLEIBAUM DPT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:SCHLEIBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:978-884-0607
Mailing Address - Street 1:30 TOZER RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-5510
Mailing Address - Country:US
Mailing Address - Phone:978-712-9081
Mailing Address - Fax:
Practice Address - Street 1:30 TOZER RD STE 201
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5510
Practice Address - Country:US
Practice Address - Phone:978-712-9081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy