Provider Demographics
NPI:1124114293
Name:SCHLEGEL, VERONICA (PT)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:SCHLEGEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 UTILITY RD
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-3349
Mailing Address - Country:US
Mailing Address - Phone:617-730-5337
Mailing Address - Fax:
Practice Address - Street 1:535 SOUTH MAIN ST
Practice Address - Street 2:, 2ND FLOOR
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368
Practice Address - Country:US
Practice Address - Phone:781-961-3370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9551225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1096093OtherAETNA
MAY68461OtherBC
MA468209OtherTUFTS
MA468209OtherTUFTS