MEDICARE: MATTHEW RAJOTTE RPT

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	PT01519	RI
2	225100000X	Physical Therapist	15386	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	478826	OTHER	MA	TUFTS HEALTH PLAN
2	AA59845	OTHER	MA	HARVARD PILGRIM HEALTH

General Provider Information

NPI Number	:	1528080033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW RAJOTTE RPT

Provider Business Mailing Address
First Line	:	1 CREDIT UNION WAY FL 3
Second Line	:
City	:	RANDOLPH
State	:	MA
Zip	:	02368-4633
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1095 WASHINGTON ST
Second Line	:
City	:	ATTLEBORO
State	:	MA
Zip	:	02703
Country	:	US
Telephone Number	:	508-761-9000
Fax Number	:	508-761-9111

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	10/16/2019

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