Healthcare Provider Details

I. General information

NPI: 1184649436
Provider Name (Legal Business Name): THOMAS MICHAEL PAPPAS M.S., OTR/L, CHT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 04/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 S HUNTINGTON AVE
BOSTON MA
02130-4817
US

IV. Provider business mailing address

60 EVANS ST
WATERTOWN MA
02472-2150
US

V. Phone/Fax

Practice location:
  • Phone: 617-232-9500
  • Fax: 857-364-4513
Mailing address:
  • Phone: 617-470-9799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5265
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: