MEDICARE: MR. ANDREW RICHARD ASZTALOS PT, DPT

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		MA

General Provider Information

NPI Number	:	1225419708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDREW RICHARD ASZTALOS PT, DPT

Provider Business Mailing Address
First Line	:	274 WILLOW ST
Second Line	:
City	:	STOUGHTON
State	:	MA
Zip	:	02072-1050
Country	:	US
Telephone Number	:	781-864-9515
Fax Number	:

Provider Business Practice Location Address
First Line	:	534 MAIN ST
Second Line	:
City	:	WEYMOUTH
State	:	MA
Zip	:	02190-1872
Country	:	US
Telephone Number	:	781-340-6800
Fax Number	:

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

Provider Enumeration Date	:	06/10/2015
Last Update Date	:	03/17/2018

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