MEDICARE: MRS. AUBREY L PHILBRICK MSPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	16590	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6440025	OTHER	MA	UNITED HEALTHCARE
2	8211	OTHER	MA	NEIGHBORHOOD HEALTH PLAN
3	467829	OTHER	MA	TUFTS HEALTH PLAN
4	603413	OTHER	MA	HARVARD PILGRIM
5	Y68232	OTHER	MA	BLUE CROSS

General Provider Information

NPI Number	:	1033164660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AUBREY L PHILBRICK MSPT

Provider Business Mailing Address
First Line	:	259 BEACON ST
Second Line	:	APT. 53
City	:	BOSTON
State	:	MA
Zip	:	02116-1209
Country	:	US
Telephone Number	:	617-480-7587
Fax Number	:

Provider Business Practice Location Address
First Line	:	653 SUMMER ST
Second Line	:	SECOND FLOOR
City	:	BOSTON
State	:	MA
Zip	:	02210-2108
Country	:	US
Telephone Number	:	617-269-6262
Fax Number	:	617-269-1068

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	07/08/2007

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