Provider Demographics
NPI:1215083019
Name:LORRAINE E. MACDONALD, PT
Entity type:Organization
Organization Name:LORRAINE E. MACDONALD, PT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MACDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:978-422-8998
Mailing Address - Street 1:16 ROWLEY HILL RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:MA
Mailing Address - Zip Code:01564-2123
Mailing Address - Country:US
Mailing Address - Phone:978-422-8998
Mailing Address - Fax:978-422-7899
Practice Address - Street 1:16 ROWLEY HILL RD
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:MA
Practice Address - Zip Code:01564-2123
Practice Address - Country:US
Practice Address - Phone:978-422-8998
Practice Address - Fax:978-422-7899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5824225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0387606Medicaid
MAY66130OtherBCBS MASS