Provider Demographics
NPI:1205125390
Name:GARABEDIAN, LORI A (PT)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:A
Last Name:GARABEDIAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:A
Other - Last Name:SHILANSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1 BERKSHIRE SQ
Mailing Address - Street 2:SUITE 109
Mailing Address - City:ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01220-1300
Mailing Address - Country:US
Mailing Address - Phone:413-743-2600
Mailing Address - Fax:413-743-2622
Practice Address - Street 1:1 BERKSHIRE SQ
Practice Address - Street 2:SUITE 109
Practice Address - City:ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01220-1300
Practice Address - Country:US
Practice Address - Phone:413-743-2600
Practice Address - Fax:413-743-2622
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9465225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist