Provider Demographics
NPI:1356624050
Name:NORTH SHORE MYOFASCIAL PHYSICAL THERAPY P.C.
Entity type:Organization
Organization Name:NORTH SHORE MYOFASCIAL PHYSICAL THERAPY P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:603-787-9000
Mailing Address - Street 1:85 SINCLAIR RD
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVERHILL
Mailing Address - State:NH
Mailing Address - Zip Code:03774-5963
Mailing Address - Country:US
Mailing Address - Phone:603-787-9000
Mailing Address - Fax:603-787-9999
Practice Address - Street 1:85 SINCLAIR RD
Practice Address - Street 2:
Practice Address - City:NORTH HAVERHILL
Practice Address - State:NH
Practice Address - Zip Code:03774-5963
Practice Address - Country:US
Practice Address - Phone:516-220-8835
Practice Address - Fax:631-996-2958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-20
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH261QP2000X
NY024051261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100060327Medicare UPIN