Healthcare Provider Details

I. General information

NPI: 1215362330
Provider Name (Legal Business Name): DIANNA MARIE ABRAMS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2013
Last Update Date: 09/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 LAUREL AVE
WELLESLEY MA
02481-7523
US

IV. Provider business mailing address

31 HERRICK RD # 5
NEWTON CENTRE MA
02459-2239
US

V. Phone/Fax

Practice location:
  • Phone: 781-237-5585
  • Fax: 781-237-5633
Mailing address:
  • Phone: 617-840-4619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number20652
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: