Provider Demographics
NPI:1952426132
Name:ELITE PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:ELITE PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:SALMINEN
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:978-774-3888
Mailing Address - Street 1:235 NEWBURY ST
Mailing Address - Street 2:ROUTE 1 NORTHBOUND
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1001
Mailing Address - Country:US
Mailing Address - Phone:978-774-3888
Mailing Address - Fax:978-774-2992
Practice Address - Street 1:235 NEWBURY ST
Practice Address - Street 2:ROUTE 1 NORTHBOUND
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1001
Practice Address - Country:US
Practice Address - Phone:978-774-3888
Practice Address - Fax:978-774-2992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA245261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA22391OtherHARVARD PILGRIM
MA0037371OtherNEIGHBORHOOD HEALTH
MA93422OtherFALLON COMMUNITY
MA96530301OtherNETWORK HEALTH
MA462411OtherTUFTS HEALTH CARE
MAAA22391OtherHEALTH PLANS INCORPORATED
MAY651384OtherBLUE CROSS BLUE SHIELD
MA0037371OtherNEIGHBORHOOD HEALTH
MA462411OtherTUFTS HEALTH CARE
MA462411Medicare ID - Type UnspecifiedTUFTS MEDICARE PREFERRED