Provider Demographics
NPI:1457432254
Name:NESTOR, STEPHEN F (DPT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:F
Last Name:NESTOR
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 HAROLD K WATERSON LN
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-6406
Mailing Address - Country:US
Mailing Address - Phone:617-970-7881
Mailing Address - Fax:
Practice Address - Street 1:60 HAROLD K WATERSON LN
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-6406
Practice Address - Country:US
Practice Address - Phone:617-970-7881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10934225100000X
RIPT022962251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY67501OtherBLUECROSS BLUESHIELD
MA0717100Medicaid
MA466539OtherTUFTS