Provider Demographics
NPI:1285730713
Name:DRAC PT INC
Entity type:Organization
Organization Name:DRAC PT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-326-8332
Mailing Address - Street 1:200 PROVIDENCE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026
Mailing Address - Country:US
Mailing Address - Phone:781-326-8332
Mailing Address - Fax:781-326-8262
Practice Address - Street 1:200 PROVIDENCE HIGHWAY
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026
Practice Address - Country:US
Practice Address - Phone:781-326-8332
Practice Address - Fax:781-326-8262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
817690OtherAETNA
CH2345OtherRAILROAD MEDICARE
MA732816OtherTUFTS
MAY61013OtherBLUE CROSS BLUE SHIELD
613720OtherHARVARD PILGRIM HLTH CARE
6400217OtherUNITED HEALTHCARE
MAPT0078Medicare ID - Type Unspecified