Healthcare Provider Details

I. General information

NPI: 1962372813
Provider Name (Legal Business Name): MULTIPLE SCLEROSIS SPECIALTY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 BATTERYMARCH PARK STE 105
QUINCY MA
02169-7500
US

IV. Provider business mailing address

3 BATTERYMARCH PARK STE 105
QUINCY MA
02169-7500
US

V. Phone/Fax

Practice location:
  • Phone: 617-404-8959
  • Fax: 617-404-8933
Mailing address:
  • Phone: 617-404-8959
  • Fax: 617-404-8933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JOHN MARMAROU
Title or Position: OWNER/EXECUTIVE DIRECTOR
Credential: DPT
Phone: 609-202-5353