Provider Demographics
NPI:1760627673
Name:MCQUAID, PAULA (PT, MT, CST)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:MCQUAID
Suffix:
Gender:F
Credentials:PT, MT, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GREGLEN AVE
Mailing Address - Street 2:BOX #108
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02554-2830
Mailing Address - Country:US
Mailing Address - Phone:508-228-7577
Mailing Address - Fax:508-228-7571
Practice Address - Street 1:37 OLD SOUTH RD
Practice Address - Street 2:BUILDING C #9
Practice Address - City:NANTUCKET
Practice Address - State:MA
Practice Address - Zip Code:02554-7003
Practice Address - Country:US
Practice Address - Phone:508-228-7577
Practice Address - Fax:508-228-7571
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11039225100000X
225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist