Provider Demographics
NPI:1245387018
Name:GERETY, JOANNA M (PT)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:M
Last Name:GERETY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:JOANNA
Other - Middle Name:M
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:15 RYE STREET
Mailing Address - Street 2:STE 125 ABILITIES REHABILITATION CENTER, LLC
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801
Mailing Address - Country:US
Mailing Address - Phone:603-610-2200
Mailing Address - Fax:603-610-2202
Practice Address - Street 1:101 CAMBRIDGE STREET
Practice Address - Street 2:C/O ORTHOPAEDICS PLUS
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-3766
Practice Address - Country:US
Practice Address - Phone:781-229-8011
Practice Address - Fax:781-229-8374
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2912225100000X
MA19470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH08Y005403NH01OtherANTHEM PROVIDER NUMBER
NH542065286OtherTAX IDENTIFICATION NUMBER
MA04-3115319OtherTAX ID ORTHOPAEDICS PLUS
NH626470OtherHPHC PROVIDER NUMBER
NH542065286OtherTAX IDENTIFICATION NUMBER