Provider Demographics
NPI:1851970685
Name:PARADIS, MADELINE JO (DPT)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:JO
Last Name:PARADIS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:JO
Other - Last Name:FUCHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:607 BOYLSTON ST FL 4
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-3604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8 MARKET PLACE DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1693
Practice Address - Country:US
Practice Address - Phone:207-363-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4779225100000X
MEPT5917225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist