MEDICARE: STEPHEN F NESTOR 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	10934	MA
2	2251X0800X	Orthopedic Physical Therapist	PT02296	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y67501	OTHER	MA	BLUECROSS BLUESHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	466539	OTHER	MA	TUFTS

General Provider Information

NPI Number	:	1457432254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN F NESTOR D.P.T.

Provider Business Mailing Address
First Line	:	60 HAROLD K WATERSON LN
Second Line	:
City	:	NORTH ATTLEBORO
State	:	MA
Zip	:	02760-6406
Country	:	US
Telephone Number	:	617-970-7881
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 HAROLD K WATERSON LN
Second Line	:
City	:	NORTH ATTLEBORO
State	:	MA
Zip	:	02760-6406
Country	:	US
Telephone Number	:	617-970-7881
Fax Number	:

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	10/14/2013

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