Provider Demographics
NPI:1912175571
Name:MCHUGH, JASON B (DPT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:B
Last Name:MCHUGH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:133 PETERBOROUGH ST
Mailing Address - Street 2:# 12A
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-4211
Mailing Address - Country:US
Mailing Address - Phone:617-543-3351
Mailing Address - Fax:
Practice Address - Street 1:653 SUMMER ST
Practice Address - Street 2:FLOOR 2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02210-2108
Practice Address - Country:US
Practice Address - Phone:617-269-6262
Practice Address - Fax:617-269-1068
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18163225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist