Provider Demographics
NPI:1598905358
Name:ROBERT VERZONE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:ROBERT VERZONE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:VERZONE
Authorized Official - Suffix:SR
Authorized Official - Credentials:PT
Authorized Official - Phone:781-293-2525
Mailing Address - Street 1:13 PADDINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4947
Mailing Address - Country:US
Mailing Address - Phone:508-747-2289
Mailing Address - Fax:
Practice Address - Street 1:284 MONPONSETT ST
Practice Address - Street 2:SUITE 102
Practice Address - City:HALIFAX
Practice Address - State:MA
Practice Address - Zip Code:02338-1430
Practice Address - Country:US
Practice Address - Phone:781-293-2525
Practice Address - Fax:781-293-2828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2914225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA499223OtherTUFTS HEALTH PLAN
MAAA142725OtherHARVARD PILGRIM HEALTHCARE
MA70010000Y61555OtherBLUE CROSS & BLUE SHIELD OF MASSACHUSETTS (HMO)
1017401Medicare UPIN