Healthcare Provider Details

I. General information

NPI: 1376618009
Provider Name (Legal Business Name): BETH FASANO PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 IPSWICH RD
TOPSFIELD MA
01983-1549
US

IV. Provider business mailing address

50 CENTRAL ST
TOPSFIELD MA
01983-1824
US

V. Phone/Fax

Practice location:
  • Phone: 978-887-0008
  • Fax: 978-887-0009
Mailing address:
  • Phone: 978-887-6498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number926
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3821
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: