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Organization
PERSONAL PT
Active
Organization
PERSONAL PT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANSARI DPT (OWNER/PRESIDENT)
(617) 992-8782
Entity
Organization
Contact information
Practice address
87 GAINSBOROUGH ST APT 408, BOSTON, MA 02115-6537
(617) 992-8782
Mailing address
87 GAINSBOROUGH ST APT 408, BOSTON, MA 02115-6537
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053702068
TYPE I NPI
—
Enumeration date
08/13/2019
Last updated
09/24/2024
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