Provider Demographics
NPI:1780863233
Name:PEREIRA, TERRI LYNN (PT)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:LYNN
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:PT
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Other - Credentials:
Mailing Address - Street 1:221 BOSTON POST RD E
Mailing Address - Street 2:SUITE 270
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3527
Mailing Address - Country:US
Mailing Address - Phone:508-481-5519
Mailing Address - Fax:508-481-6106
Practice Address - Street 1:221 BOSTON POST RD E
Practice Address - Street 2:SUITE 270
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3527
Practice Address - Country:US
Practice Address - Phone:508-481-5519
Practice Address - Fax:508-481-6106
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA7013225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY68396Medicare PIN