Provider Demographics
NPI:1043546948
Name:CRAY PHYSICAL THERAPY & ASSOCIATES
Entity type:Organization
Organization Name:CRAY PHYSICAL THERAPY & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:E
Authorized Official - Last Name:CRAY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT CSCS
Authorized Official - Phone:339-987-4856
Mailing Address - Street 1:1681 WASHINGTON ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-7948
Mailing Address - Country:US
Mailing Address - Phone:339-987-4856
Mailing Address - Fax:339-987-4858
Practice Address - Street 1:1681 WASHINGTON ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-7948
Practice Address - Country:US
Practice Address - Phone:339-987-4856
Practice Address - Fax:339-987-4858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17916261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0014113Medicare PIN