Healthcare Provider Details

I. General information

NPI: 1881557148
Provider Name (Legal Business Name): PIERRE-ANDRE KESLY PASCAL DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 MIDDLESEX TPKE STE 101L
BEDFORD MA
01730-1417
US

IV. Provider business mailing address

54 MIDDLESEX TPKE STE 101L
BEDFORD MA
01730-1417
US

V. Phone/Fax

Practice location:
  • Phone: 781-229-8011
  • Fax: 781-229-8374
Mailing address:
  • Phone: 781-229-8011
  • Fax: 781-229-8374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number28096
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: