MEDICARE: PATRICE D BAIN MS, OTR/L

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	225XL0004X	Low Vision Occupational Therapist	7552	MA

General Provider Information

NPI Number	:	1659658334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICE D BAIN MS, OTR/L

Provider Business Mailing Address
First Line	:	1 POST OFFICE SQ
Second Line	:	SUITE 3600
City	:	BOSTON
State	:	MA
Zip	:	02109-2106
Country	:	US
Telephone Number	:	866-590-0011
Fax Number	:	888-445-3937

Provider Business Practice Location Address
First Line	:	1 POST OFFICE SQ
Second Line	:	SUITE 3600
City	:	BOSTON
State	:	MA
Zip	:	02109-2106
Country	:	US
Telephone Number	:	866-590-0011
Fax Number	:	888-445-3937

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

Provider Enumeration Date	:	11/09/2011
Last Update Date	:	11/09/2011

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