Provider Demographics
NPI:1992207252
Name:DEFREITAS, ELAINE PAULA (PT,DPT)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:PAULA
Last Name:DEFREITAS
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:MISS
Other - First Name:ELAINE
Other - Middle Name:PAULA
Other - Last Name:CARPENTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,DPT
Mailing Address - Street 1:744 POST RD
Mailing Address - Street 2:
Mailing Address - City:BOWDOINHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04008-6015
Mailing Address - Country:US
Mailing Address - Phone:207-841-7312
Mailing Address - Fax:
Practice Address - Street 1:50 REPUBLIC AVE
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1136
Practice Address - Country:US
Practice Address - Phone:207-729-9961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT3689225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist