Provider Demographics
NPI:1598063174
Name:SYNERGY REHAB AND PHYSICAL THERAPY
Entity Type:Organization
Organization Name:SYNERGY REHAB AND PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:HUONG
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-533-8844
Mailing Address - Street 1:1016 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-3005
Mailing Address - Country:US
Mailing Address - Phone:617-533-8844
Mailing Address - Fax:617-533-8845
Practice Address - Street 1:1558 DORCHESTER AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02122-1354
Practice Address - Country:US
Practice Address - Phone:617-533-8844
Practice Address - Fax:617-533-8845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty