Provider Demographics
NPI:1346202074
Name:BULLETT, NANCY P (PT)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:P
Last Name:BULLETT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2830
Mailing Address - Country:US
Mailing Address - Phone:413-663-7895
Mailing Address - Fax:
Practice Address - Street 1:40 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-3436
Practice Address - Country:US
Practice Address - Phone:413-663-7862
Practice Address - Fax:413-663-7864
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7297225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY6817Medicare PIN