MEDICARE: MARTHA MORGAN 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	11448	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y68220	OTHER	MA	BLUE CROSS BLUE SHIELD
2	6440025	OTHER	MA	UNITED HEALTH PLAN
3	603413	OTHER	MA	HARVARD PILGRIM
4	8211	OTHER	MA	NEIGHBORHOOD HEALTH PLAN
5	470119	OTHER	MA	TUFTS HEALTH PLAN

General Provider Information

NPI Number	:	1962516534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTHA MORGAN MSPT

Provider Business Mailing Address
First Line	:	6 LAWLER RD
Second Line	:
City	:	MEDFORD
State	:	MA
Zip	:	02155-2131
Country	:	US
Telephone Number	:	781-483-9732
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	:	08/19/2006
Last Update Date	:	07/08/2007

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Directions to “ MARTHA MORGAN MSPT” Practice Location

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