Provider Demographics
NPI:1205057171
Name:PARKINSON, SANDRA J (PT)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:J
Last Name:PARKINSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 OLD SILVER LN
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-4318
Mailing Address - Country:US
Mailing Address - Phone:508-495-2855
Mailing Address - Fax:
Practice Address - Street 1:33 HIGHFIELD DR
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2303
Practice Address - Country:US
Practice Address - Phone:508-548-7491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPA Y68866Medicare ID - Type UnspecifiedMEDICARE