MEDICARE: MR. ROBERT MAXIMILIAAN KAULBACH D.P.T

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	15143	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y68562	OTHER	MA	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043282601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT MAXIMILIAAN KAULBACH D.P.T

Provider Business Mailing Address
First Line	:	210 COMMERCE WAY
Second Line	:	SUITE 120
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-8200
Country	:	US
Telephone Number	:	207-439-2675
Fax Number	:	207-439-4965

Provider Business Practice Location Address
First Line	:	3 RUNDLETT WAY
Second Line	:
City	:	MIDDLETON
State	:	MA
Zip	:	01949-2500
Country	:	US
Telephone Number	:	978-624-7149
Fax Number	:	978-624-7149

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	02/22/2013

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