Provider Demographics
NPI:1639318926
Name:LAMPROS, RACHEL ELIZABETH (DPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:LAMPROS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 CAMBRIDGE ST
Mailing Address - Street 2:SUITE 470
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2743
Mailing Address - Country:US
Mailing Address - Phone:617-643-9999
Mailing Address - Fax:617-643-0822
Practice Address - Street 1:175 CAMBRIDGE ST
Practice Address - Street 2:SUITE 470
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2743
Practice Address - Country:US
Practice Address - Phone:617-643-9999
Practice Address - Fax:617-643-0822
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT2180225100000X
MA18339225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI659080582Medicare PIN