Provider Demographics
NPI:1659576916
Name:DUCHARME, RONALD
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:DUCHARME
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 ADAMS ROAD.
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01360-0000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:92 LAUREL ST.
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-0000
Practice Address - Country:US
Practice Address - Phone:413-774-4134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA109225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant