Provider Demographics
NPI:1902077399
Name:DUFFY, BARON EDWARD (PT, DPT, OCS)
Entity Type:Individual
Prefix:DR
First Name:BARON
Middle Name:EDWARD
Last Name:DUFFY
Suffix:
Gender:M
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 TWO PONDS RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2221
Mailing Address - Country:US
Mailing Address - Phone:508-356-3952
Mailing Address - Fax:508-437-2597
Practice Address - Street 1:634 N FALMOUTH HWY UNIT 10
Practice Address - Street 2:
Practice Address - City:NORTH FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02556-0326
Practice Address - Country:US
Practice Address - Phone:508-356-3952
Practice Address - Fax:508-437-2597
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18177225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist