Provider Demographics
NPI:1316933302
Name:CARMAN, BRENDAN J (PT)
Entity type:Individual
Prefix:MR
First Name:BRENDAN
Middle Name:J
Last Name:CARMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:506 PLAIN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-2744
Mailing Address - Country:US
Mailing Address - Phone:781-319-0024
Mailing Address - Fax:781-319-0088
Practice Address - Street 1:506 PLAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-2744
Practice Address - Country:US
Practice Address - Phone:781-319-0024
Practice Address - Fax:781-319-0088
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA15242225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY68230OtherBCBS OF MA
MAAA40694OtherHARVARD PILGRIM HEALTHCAR
MADE3666OtherMEDICARE RAILROAD
MA0324515Medicaid
MAAA40694OtherHARVARD PILGRIM HEALTHCAR