Provider Demographics
NPI:1306157987
Name:CAPE COD ORTHOPAEDICS AND SPORTS MEDICINE PHYSICAL THERAPY
Entity type:Organization
Organization Name:CAPE COD ORTHOPAEDICS AND SPORTS MEDICINE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-775-8282
Mailing Address - Street 1:130 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3825
Mailing Address - Country:US
Mailing Address - Phone:508-775-8282
Mailing Address - Fax:508-775-1414
Practice Address - Street 1:130 NORTH ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3825
Practice Address - Country:US
Practice Address - Phone:508-775-8282
Practice Address - Fax:508-775-1414
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPE COD ORTHOPAEDICS AND SPORTS MEDICINE, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
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
MAM15397OtherBLUE CROSS BLUE SHIELD OF MASSACHUSETTS