Active NPI
Brenda Fran Mack, PT
- Physical Therapist
- Marlborough, MA
National Provider Identifier
1063576353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11463
- Practice address
- 157 Union St
Marlborough, MA 01752-1228 - Phone
- (508) 486-5900
- NPI assigned
- Dec 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11463 | MA | Primary |
Addresses
Primary practice location
157 Union St
Marlborough, MA 01752-1228
Mailing address
21 Smith Rd
Shrewsbury, MA 01545-4568
Phone (508) 792-3908
Other names 1
- Brenda Fran Novick
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11463 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063576353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 SMITH RD",
"city": "SHREWSBURY",
"state": "MA",
"postal_code": "015454568",
"telephone_number": "508-792-3908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "157 UNION ST",
"city": "MARLBOROUGH",
"state": "MA",
"postal_code": "017521228",
"telephone_number": "508-486-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "BRENDA",
"middle_name": "FRAN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "11463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BRENDA",
"last_name": "NOVICK",
"middle_name": "FRAN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Marlborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.