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General NPI Number Information
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NPI Number | 1528363116
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Entity Type | Organization
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Legal Business Name | STEP AHEAD PHYSICAL THERAPY
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Dates
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Enumeration Date | 01/13/2011
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Last Update Date | 03/02/2011
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Provider Practice Location Address
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Address Line | 5 MIDDLESEX AVE SUITE 203
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City | SOMERVILLE
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State | MA
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Zip | 02145-1102
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Country | US
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Telephone | 617-240-9303
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Fax |
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Provider Business Mailing Address
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Address Line | 111 WATER ST APT 7
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City | BEVERLY
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State | MA
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Zip | 01915-5060
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW CIARLETTA
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Credential |
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Telephone | 617-240-9303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 11191
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License Number State | MA
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