Provider Demographics
NPI:1467632703
Name:CRUPI, MARIBETH (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARIBETH
Middle Name:
Last Name:CRUPI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARIBETH
Other - Middle Name:
Other - Last Name:CRUPI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:10 ELIZABETH DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-3397
Mailing Address - Country:US
Mailing Address - Phone:978-658-6059
Mailing Address - Fax:
Practice Address - Street 1:10 ELIZABETH DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-3397
Practice Address - Country:US
Practice Address - Phone:978-658-6059
Practice Address - Fax:978-694-9273
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-04
Last Update Date:2007-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5468225100000X, 2251G0304X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic