Provider Demographics
NPI:1932130465
Name:BURLINGTON PHYSICAL THERAPY, PC, DBA ORTHOPAEDICS PLUS
Entity Type:Organization
Organization Name:BURLINGTON PHYSICAL THERAPY, PC, DBA ORTHOPAEDICS PLUS
Other - Org Name:ORTHOPAEDICS PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEZICK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:781-229-8011
Mailing Address - Street 1:54 MIDDLESEX TPKE STE 101L
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1417
Mailing Address - Country:US
Mailing Address - Phone:781-229-8011
Mailing Address - Fax:781-229-8374
Practice Address - Street 1:54 MIDDLESEX TPKE STE 101L
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730
Practice Address - Country:US
Practice Address - Phone:781-229-8011
Practice Address - Fax:781-229-8374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY65610OtherBCBS
MA41795OtherFALLON
MA9710680Medicaid
MA714092OtherTUFTS
MA110067737Medicaid
MA604487OtherHARVARD PILGRIM