Provider Demographics
NPI:1316004179
Name:SOUTH SHORE THERAPIES
Entity Type:Organization
Organization Name:SOUTH SHORE THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SZKLUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-335-6663
Mailing Address - Street 1:163 LIBBEY INDUSTRIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-3137
Mailing Address - Country:US
Mailing Address - Phone:781-335-6663
Mailing Address - Fax:781-335-6686
Practice Address - Street 1:163 LIBBEY INDUSTRIAL PKWY
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3137
Practice Address - Country:US
Practice Address - Phone:781-335-6663
Practice Address - Fax:781-335-6686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAOG0055OtherBCBS OT PROVIDER ID
MA616937OtherTUFTS PROVIDER ID
MASG0033OtherBCBS SPEECH PROVIDER ID