MEDICARE: MR. STEPHEN JAMES MESSINEO PT, DPT

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	13092	MA

General Provider Information

NPI Number	:	1356331300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN JAMES MESSINEO PT, DPT

Provider Business Mailing Address
First Line	:	489 WASHINGTON ST STE 200
Second Line	:
City	:	AUBURN
State	:	MA
Zip	:	01501-5709
Country	:	US
Telephone Number	:	774-696-8309
Fax Number	:	508-721-0100

Provider Business Practice Location Address
First Line	:	489 WASHINGTON ST STE 200
Second Line	:
City	:	AUBURN
State	:	MA
Zip	:	01501-5709
Country	:	US
Telephone Number	:	774-696-8309
Fax Number	:	508-721-0100

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	05/24/2024

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