Healthcare Provider Details

I. General information

NPI: 1710591144
Provider Name (Legal Business Name): LUCAS ZAFFINO PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2020
Last Update Date: 09/02/2020
Certification Date: 09/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 ROCHE BROS WAY STE 1
NORTH EASTON MA
02356-1030
US

IV. Provider business mailing address

20 ROCHE BROS WAY STE 1
NORTH EASTON MA
02356-1030
US

V. Phone/Fax

Practice location:
  • Phone: 781-573-1686
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number25004
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: