Provider Demographics
NPI:1700900933
Name:DENOY PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:DENOY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNERPHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DENOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-228-5635
Mailing Address - Street 1:2 SHEPARD RD
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-7412
Mailing Address - Country:US
Mailing Address - Phone:781-228-5635
Mailing Address - Fax:
Practice Address - Street 1:2 SHEPARD RD
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-7412
Practice Address - Country:US
Practice Address - Phone:781-228-5635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9702261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY68725Medicare ID - Type Unspecified