Provider Demographics
NPI:1467925164
Name:BARBARA B. DEMATTEO, PT
Entity Type:Organization
Organization Name:BARBARA B. DEMATTEO, PT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:B
Authorized Official - Last Name:DEMATTEO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:603-358-9880
Mailing Address - Street 1:70 ISLAND STREET
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431
Mailing Address - Country:US
Mailing Address - Phone:603-358-9880
Mailing Address - Fax:603-358-9951
Practice Address - Street 1:70 ISLAND STREET
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431
Practice Address - Country:US
Practice Address - Phone:603-358-9880
Practice Address - Fax:603-358-9951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3076656Medicaid