Provider Demographics
NPI:1215111984
Name:TEIXEIRA, AIMEE (PT)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:TEIXEIRA
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 1:8 QUAIL TRL
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHATHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02659-1401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8 QUAIL TRL
Practice Address - Street 2:
Practice Address - City:SOUTH CHATHAM
Practice Address - State:MA
Practice Address - Zip Code:02659-1401
Practice Address - Country:US
Practice Address - Phone:508-775-6240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA158382251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics