Healthcare Provider Details

I. General information

NPI: 1649679739
Provider Name (Legal Business Name): EMILY ROUSSI DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY VELAZQUEZ DPT

II. Dates (important events)

Enumeration Date: 08/14/2014
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MOODY ST
LUDLOW MA
01056-1228
US

IV. Provider business mailing address

300 BIRNIE AVE STE 201
SPRINGFIELD MA
01107-1121
US

V. Phone/Fax

Practice location:
  • Phone: 413-785-4666
  • Fax: 413-610-1053
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number21334
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: