Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 24379 | MA |
Y | 2251X0800X | Physical Therapist - Orthopedic | 24379 | MA |
NPI | 1083250526 |
---|---|
Provider Name | Stephen J Debay |
First Address | North Reading, MA 01864-3172 |
Second Address | North Reading, MA 01864-3172 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2019 |
Last Update Date | 19/11/2019 |