Provider Demographics
NPI:1811504681
Name:BASKIND, DIANNE MCKIE (PT)
Entity type:Individual
Prefix:
First Name:DIANNE
Middle Name:MCKIE
Last Name:BASKIND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 LANEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3659
Mailing Address - Country:US
Mailing Address - Phone:508-561-1701
Mailing Address - Fax:
Practice Address - Street 1:214 N MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1131
Practice Address - Country:US
Practice Address - Phone:508-647-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4181225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist