Provider Demographics
NPI:1639309552
Name:REPETTO, ELEANOR J (PT)
Entity Type:Individual
Prefix:MS
First Name:ELEANOR
Middle Name:J
Last Name:REPETTO
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 1:50 ARROWHEAD RD
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-5003
Mailing Address - Country:US
Mailing Address - Phone:781-934-0655
Mailing Address - Fax:
Practice Address - Street 1:50 ARROWHEAD RD
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-5003
Practice Address - Country:US
Practice Address - Phone:781-934-0655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1693225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist