Provider Demographics
NPI:1497536809
Name:EWALD, ROBIN (PT)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:
Last Name:EWALD
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 1:4 WHISPERING LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-1190
Mailing Address - Country:US
Mailing Address - Phone:617-429-7939
Mailing Address - Fax:
Practice Address - Street 1:15 OAK ST STE 1
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2470
Practice Address - Country:US
Practice Address - Phone:781-444-1614
Practice Address - Fax:781-444-9260
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPTL8883225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist