Provider Demographics
NPI:1629271218
Name:BEHBAKHT, FATEMEH MEHRY (PTA)
Entity Type:Individual
Prefix:
First Name:FATEMEH
Middle Name:MEHRY
Last Name:BEHBAKHT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 BOSTON AVE
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-4236
Mailing Address - Country:US
Mailing Address - Phone:781-391-5151
Mailing Address - Fax:
Practice Address - Street 1:196 BOSTON AVE
Practice Address - Street 2:SUITE 2200
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-4236
Practice Address - Country:US
Practice Address - Phone:781-391-5151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist