Provider Demographics
NPI:1962548024
Name:MEETING STREET MASSACHUSETTS
Entity type:Organization
Organization Name:MEETING STREET MASSACHUSETTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OUTPATIENT REHAB
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:ISHERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-533-9250
Mailing Address - Street 1:1 POSA PLACE
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-2511
Mailing Address - Country:US
Mailing Address - Phone:508-996-3391
Mailing Address - Fax:508-996-3397
Practice Address - Street 1:1 POSA PLACE
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-2511
Practice Address - Country:US
Practice Address - Phone:508-996-3391
Practice Address - Fax:508-996-3397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000025520OtherBOSTON MEDICAL REHAB
MA1399993Medicaid
MA682632OtherUNITED HEALTH CARE REHAB
MA0006553OtherNEIGHBORHOOD HEALTH REHAB
MA000000025521OtherBOSTON MEDICAL REHAB
MA601047OtherHARVARD PILGRIM REHAB
MA695483OtherTUFTS REHAB