Healthcare Provider Details

I. General information

NPI: 1225732571
Provider Name (Legal Business Name): PATRICIA BEDARD PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA QUARTARARO

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 WATER ST
HAVERHILL MA
01830-6213
US

IV. Provider business mailing address

394 SALEM ST
HAVERHILL MA
01835-7621
US

V. Phone/Fax

Practice location:
  • Phone: 978-374-0707
  • Fax:
Mailing address:
  • Phone: 339-223-2848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number9212
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: