Healthcare Provider Details

I. General information

NPI: 1316514144
Provider Name (Legal Business Name): BRIAN TRANFAGLIA DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 06/09/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

748 ASHLEY BOULEVARD
NEW BEDFORD MA
02745
US

IV. Provider business mailing address

10 HITCHING POST RD
MATTAPOISETT MA
02739-1522
US

V. Phone/Fax

Practice location:
  • Phone: 508-995-9000
  • Fax:
Mailing address:
  • Phone: 508-858-7278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number25480
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: