=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659170488
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CURATED PT & WELLNESS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/12/2025
-----------------------------------------------------
Last Update Date | 03/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 88 BRIDGE ST
-----------------------------------------------------
City | DEDHAM
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02026-1702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-963-3098
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 425 EAST ST
-----------------------------------------------------
City | DEDHAM
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02026-3019
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-963-3098
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | SUREN AZIZIAN
-----------------------------------------------------
Credential | PT
-----------------------------------------------------
Telephone | 508-963-3098
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------