Provider Demographics
NPI:1861950115
Name:FIORELLO, AMY (PT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:FIORELLO
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:GENERATIONS OUT PT REHAB
Mailing Address - Street 2:115 HOLLISTON ST
Mailing Address - City:MEDWAY
Mailing Address - State:MA
Mailing Address - Zip Code:02053
Mailing Address - Country:US
Mailing Address - Phone:508-533-9893
Mailing Address - Fax:508-533-5775
Practice Address - Street 1:GENERATIONS OUT PT REHAB
Practice Address - Street 2:115 HOLLISTON ST
Practice Address - City:MEDWAY
Practice Address - State:MA
Practice Address - Zip Code:02053
Practice Address - Country:US
Practice Address - Phone:508-533-9893
Practice Address - Fax:508-533-5775
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8191225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist