Provider Demographics
NPI:1154438893
Name:CHAMBERLAIN, PHILIP A (PT)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:A
Last Name:CHAMBERLAIN
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:73 NEWTON RD
Mailing Address - Street 2:STE 101
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-2424
Mailing Address - Country:US
Mailing Address - Phone:978-388-7272
Mailing Address - Fax:978-388-7373
Practice Address - Street 1:74 GRAY RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-2062
Practice Address - Country:US
Practice Address - Phone:207-797-3006
Practice Address - Fax:207-797-3002
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEPT3163174400000X
MEPT 3163225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MES400161124Medicare PIN