Provider Demographics
NPI:1356315618
Name:HARDY, TERRY EDWARD (PT)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:EDWARD
Last Name:HARDY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 MAIN ST
Mailing Address - Street 2:NORTHBOROUGH MEDICAL BUILDING
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532
Mailing Address - Country:US
Mailing Address - Phone:508-393-7298
Mailing Address - Fax:508-393-1338
Practice Address - Street 1:112 MAIN ST
Practice Address - Street 2:HARDY PHYSICAL THERAPY REHABILITATION SERVICES INC
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532
Practice Address - Country:US
Practice Address - Phone:508-393-7298
Practice Address - Fax:508-393-1338
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2215225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0325015Medicaid
MA303282OtherTUFTS
MAY65116OtherBCBS
MAY65116OtherBCBS