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NPI Code Detail

MEDICARE: HEALTH & SPORTS REHAB, INC.

MEDICARE: HEALTH & SPORTS REHAB, INC.
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
1225200000XPhysical Therapy Assistant3148MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2Y61146OTHERMABCBS

General Provider Information

NPI Number : 1861434250
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTH & SPORTS REHAB, INC.
Provider Business Mailing Address
First Line : 402A BLUE HILL AVENUE
Second Line :
City : DORCHESTER
State : MA
Zip : 02121-4308
Country : US
Telephone Number : 617-541-8825
Fax Number : 614-541-8815
Provider Business Practice Location Address
First Line : 402A BLUE HILL AVENUE
Second Line :
City : DORCHESTER
State : MA
Zip : 02121-4308
Country : US
Telephone Number : 617-541-8825
Fax Number : 614-541-8815
Authorized Official
Title or Position : MANAGER
Name : MRS. YVETTE WATSON
Credential :
Telephone Number : 617-541-8825
Provider Enumeration Date : 06/12/2006
Last Update Date : 07/23/2013

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Directions to “HEALTH & SPORTS REHAB, INC. ” Practice Location

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