Healthcare Provider Details

I. General information

NPI: 1841787306
Provider Name (Legal Business Name): EXTRA STEPS PEDIATRIC THERAPIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2018
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MILL AND MAIN PL STE 370
MAYNARD MA
01754-2671
US

IV. Provider business mailing address

35 FOREST RIDGE RD
CONCORD MA
01742-3844
US

V. Phone/Fax

Practice location:
  • Phone: 978-287-7878
  • Fax: 978-287-7879
Mailing address:
  • Phone: 978-287-7925
  • Fax: 978-287-7866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEAN A GOLDSBERRY
Title or Position: CEO
Credential:
Phone: 978-287-7914