Organization
SHAFA PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FATEMEH MEHRY BEHBAKHT (OWNER)
(781) 391-5151
Entity
Organization
Contact information
Practice address
196 BOSTON AVE, SUITE 2200, MEDFORD, MA 02155-4236
(781) 391-5151
Mailing address
196 BOSTON AVE, MEDFORD, MA 02155-4236
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1039
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9754351
—
MA
Enumeration date
09/25/2006
Last updated
08/22/2020
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