Healthcare Provider Details

I. General information

NPI: 1548592108
Provider Name (Legal Business Name): PAMELA NADINE REICH PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2010
Last Update Date: 02/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 BIGELOW ST 3RD FLOOR
CAMBRIDGE MA
02139-2384
US

IV. Provider business mailing address

6 BIGELOW STREET
CAMBRIDGE MA
02139
US

V. Phone/Fax

Practice location:
  • Phone: 617-576-7400
  • Fax: 617-576-7435
Mailing address:
  • Phone: 617-576-7400
  • Fax: 617-576-7435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6152
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: