Provider Demographics
NPI:1750414587
Name:FARIA, AMI (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:AMI
Middle Name:
Last Name:FARIA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 RELLAS RDG
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NH
Mailing Address - Zip Code:03848
Mailing Address - Country:US
Mailing Address - Phone:978-420-8021
Mailing Address - Fax:
Practice Address - Street 1:20 MAITLAND ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3534
Practice Address - Country:US
Practice Address - Phone:603-224-1319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3059225100000X
MA15462225100000X
MEPT2360225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist