Provider Demographics
NPI:1750492468
Name:LINSEY, KEITH (MS PT)
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:
Last Name:LINSEY
Suffix:
Gender:M
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 PEARL STREET
Mailing Address - Street 2:NORTH SUBURBAN ORTHOPEDIC ASSOCIATES INC
Mailing Address - City:MADLEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148
Mailing Address - Country:US
Mailing Address - Phone:781-321-8785
Mailing Address - Fax:781-321-8063
Practice Address - Street 1:721 MAIN STREET
Practice Address - Street 2:NSOA PT UNIT
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176
Practice Address - Country:US
Practice Address - Phone:781-979-2519
Practice Address - Fax:781-979-2520
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10624225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y67322OtherBCBS INDIVIDUAL
0000Y61011OtherBCBS GROUP
612930OtherTUFTS GROUP
6135212OtherHARVARD PILGRIM GROUP
Y67322OtherBCBS INDIVIDUAL
PT0027Medicare ID - Type UnspecifiedGROUP