Provider Demographics
NPI:1699179606
Name:NEIGHBORHOOD PHYSICAL THERAPY 1
Entity Type:Organization
Organization Name:NEIGHBORHOOD PHYSICAL THERAPY 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:617-461-8277
Mailing Address - Street 1:337 WESTFORD ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-2519
Mailing Address - Country:US
Mailing Address - Phone:978-455-4320
Mailing Address - Fax:978-455-4325
Practice Address - Street 1:337 WESTFORD ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-2519
Practice Address - Country:US
Practice Address - Phone:978-455-4320
Practice Address - Fax:978-455-4325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA864261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy