Healthcare Provider Details

I. General information

NPI: 1033706627
Provider Name (Legal Business Name): PAPPAS PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1181 AQUIDNECK AVE
MIDDLETOWN RI
02842-5255
US

IV. Provider business mailing address

PO BOX 20372
CRANSTON RI
02920-0944
US

V. Phone/Fax

Practice location:
  • Phone: 401-845-0840
  • Fax: 401-845-0842
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL J. PAPPAS
Title or Position: CEO/MEMBER
Credential:
Phone: 401-785-1016