Healthcare Provider Details

I. General information

NPI: 1992112791
Provider Name (Legal Business Name): NEW ENGLAND THERAPY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2014
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MOHAWK PATH
HOLLISTON MA
01746-3309
US

IV. Provider business mailing address

111 MOHAWK PATH
HOLLISTON MA
01746-3309
US

V. Phone/Fax

Practice location:
  • Phone: 774-999-9054
  • Fax: 508-429-1403
Mailing address:
  • Phone: 774-999-9054
  • Fax: 508-429-1403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name: DR. DHAVAL PRAJAPATI
Title or Position: PRESIDENT & COO
Credential: DPT
Phone: 774-999-9054