Provider Demographics
NPI:1528080033
Name:RAJOTTE, MATTHEW (RPT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:RAJOTTE
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CREDIT UNION WAY FL 3
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4633
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1095 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703
Practice Address - Country:US
Practice Address - Phone:508-761-9000
Practice Address - Fax:508-761-9111
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01519225100000X
MA15386225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA478826OtherTUFTS HEALTH PLAN
MAAA59845OtherHARVARD PILGRIM HEALTH
MA478826OtherTUFTS HEALTH PLAN