Provider Demographics
NPI:1659812667
Name:PAPPAS PHYSICAL THERAPY OF NORTH PROVIDENCE, LLC
Entity Type:Organization
Organization Name:PAPPAS PHYSICAL THERAPY OF NORTH PROVIDENCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAPPAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:401-351-0515
Mailing Address - Street 1:PO BOX 20372
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-0944
Mailing Address - Country:US
Mailing Address - Phone:401-785-1016
Mailing Address - Fax:401-785-1018
Practice Address - Street 1:1525 SMITH ST
Practice Address - Street 2:UNIT 5
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02911-2959
Practice Address - Country:US
Practice Address - Phone:401-353-8884
Practice Address - Fax:401-353-8885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty