Provider Demographics
NPI:1437250685
Name:MCLINDEN, JOHN P SR (MSPT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:P
Last Name:MCLINDEN
Suffix:SR
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:872 SMITHFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-3500
Mailing Address - Country:US
Mailing Address - Phone:401-722-0012
Mailing Address - Fax:401-722-0056
Practice Address - Street 1:872 SMITHFIELD AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-3500
Practice Address - Country:US
Practice Address - Phone:401-722-0012
Practice Address - Fax:401-722-0056
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01039225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI21334-1OtherBLUE CROSS
RI050504796OtherUNITED HEALTHCARE
RI402509OtherBLUE CHIP
RI402509OtherBLUE CHIP
RI007058421Medicare PIN