Provider Demographics
NPI:1841237690
Name:CENTERIMT BOSTON
Entity type:Organization
Organization Name:CENTERIMT BOSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-243-6571
Mailing Address - Street 1:66 UNION SQ
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-3040
Mailing Address - Country:US
Mailing Address - Phone:860-243-6572
Mailing Address - Fax:
Practice Address - Street 1:66 UNION SQ
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-3040
Practice Address - Country:US
Practice Address - Phone:860-243-6572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty