Provider Demographics
NPI:1376110361
Name:VASILIU, MORGAN (DPT)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:VASILIU
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 MAIN ST STE 310
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-3055
Mailing Address - Country:US
Mailing Address - Phone:774-421-9031
Mailing Address - Fax:
Practice Address - Street 1:577 MAIN ST STE 310
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749-3055
Practice Address - Country:US
Practice Address - Phone:774-421-9031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD284362251X0800X
MA264582251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA26458OtherLICENSE NUMBER