Provider Demographics
NPI:1427106541
Name:MARKOWSKI CUCCHIARA, MEGHAN (PT)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:MARKOWSKI CUCCHIARA
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 1:850 BOYLSTON STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467
Mailing Address - Country:US
Mailing Address - Phone:617-732-9525
Mailing Address - Fax:617-732-9574
Practice Address - Street 1:850 BOYLSTON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-2477
Practice Address - Country:US
Practice Address - Phone:617-732-9525
Practice Address - Fax:617-732-9574
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007308225100000X
MA18422225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT650001055Medicare ID - Type Unspecified