MEDICARE: KATHY LUPIEN PT

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	2891	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11358103	OTHER	NH	CAQH

General Provider Information

NPI Number	:	1538230214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY LUPIEN PT

Provider Business Mailing Address
First Line	:	PO BOX 32
Second Line	:	4 HAVERHILL RD
City	:	CHESTER
State	:	NH
Zip	:	03036-0032
Country	:	US
Telephone Number	:	603-887-7800
Fax Number	:	603-887-7801

Provider Business Practice Location Address
First Line	:	4 HAVERHILL RD
Second Line	:
City	:	CHESTER
State	:	NH
Zip	:	03036-4206
Country	:	US
Telephone Number	:	603-887-7800
Fax Number	:	603-887-7801

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	07/08/2007

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Directions to “ KATHY LUPIEN PT” Practice Location

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