Healthcare Provider Details

I. General information

NPI: 1326918525
Provider Name (Legal Business Name): ROBERTA RUBY SKERYTE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RUBY SKERYTE PT

II. Dates (important events)

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

III. Provider practice location address

379 W BROADWAY
SOUTH BOSTON MA
02127-2217
US

IV. Provider business mailing address

122 SCHOOL ST
WATERTOWN MA
02472-4249
US

V. Phone/Fax

Practice location:
  • Phone: 617-752-4138
  • Fax:
Mailing address:
  • Phone: 508-280-5926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPTL88932
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPTL88932
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL88932
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: