Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 9702 | MA |
NPI | 1053477174 |
---|---|
Provider Name | Stephen Joseph Denoy |
First Address | Braintree, MA 02184-7412 |
Second Address | Quincy, MA 02169-5058 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0395617 | (05) | MA |