MEDICARE: JOCELYN MACH 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	9905	CT
2	225100000X	Physical Therapist	22615	MA

General Provider Information

NPI Number	:	1689008096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOCELYN MACH DPT

Provider Business Mailing Address
First Line	:	1 CREDIT UNION WAY FL 3
Second Line	:
City	:	RANDOLPH
State	:	MA
Zip	:	02368-4633
Country	:	US
Telephone Number	:	781-961-3370
Fax Number	:	781-961-1291

Provider Business Practice Location Address
First Line	:	637 WASHINGTON ST STE 102
Second Line	:
City	:	BROOKLINE
State	:	MA
Zip	:	02446-4579
Country	:	US
Telephone Number	:	617-734-6135
Fax Number	:	617-734-3774

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

Provider Enumeration Date	:	08/22/2013
Last Update Date	:	08/27/2020

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