Provider Demographics
NPI:1700380177
Name:ARCHETTO, PETER JAMES (MS LAT ATC CSCS)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:JAMES
Last Name:ARCHETTO
Suffix:
Gender:M
Credentials:MS LAT ATC CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 DEAN AVE APT 4303
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-1893
Mailing Address - Country:US
Mailing Address - Phone:774-571-9865
Mailing Address - Fax:
Practice Address - Street 1:320 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02357-6875
Practice Address - Country:US
Practice Address - Phone:774-571-9865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-21
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAATL33422255A2300X
MA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer