Provider Demographics
NPI:1134982697
Name:METHUEN PEDIATRIC THERAPY LLC
Entity type:Organization
Organization Name:METHUEN PEDIATRIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGUS
Authorized Official - Suffix:
Authorized Official - Credentials:OTD
Authorized Official - Phone:978-314-8562
Mailing Address - Street 1:100 MILK ST STE 10
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-4600
Mailing Address - Country:US
Mailing Address - Phone:978-685-0659
Mailing Address - Fax:
Practice Address - Street 1:100 MILK ST STE 10
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-4600
Practice Address - Country:US
Practice Address - Phone:978-685-0659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEVELOPMENTAL TESTING OF NEW ENGLAND
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities