Provider Demographics
NPI:1285742023
Name:ARVIA PHYSICAL THERAPY
Entity type:Organization
Organization Name:ARVIA PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DURAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-360-9770
Mailing Address - Street 1:41 FAIRMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-2701
Mailing Address - Country:US
Mailing Address - Phone:617-360-9770
Mailing Address - Fax:617-360-9797
Practice Address - Street 1:41 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-2701
Practice Address - Country:US
Practice Address - Phone:617-360-9770
Practice Address - Fax:617-360-9797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9764721Medicaid
MAM21733Medicare ID - Type Unspecified