Provider Demographics
NPI:1609661792
Name:PISCHETOLA, JOSEPH (PTA)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:PISCHETOLA
Suffix:
Gender:
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 JAMIE RD
Mailing Address - Street 2:
Mailing Address - City:DUNSTABLE
Mailing Address - State:MA
Mailing Address - Zip Code:01827-1639
Mailing Address - Country:US
Mailing Address - Phone:603-566-3510
Mailing Address - Fax:
Practice Address - Street 1:15 JAMIE RD
Practice Address - Street 2:
Practice Address - City:DUNSTABLE
Practice Address - State:MA
Practice Address - Zip Code:01827-1639
Practice Address - Country:US
Practice Address - Phone:603-566-3510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8317225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty