Chester Ryan Ramirez Azurin, MSPT

Individual provider Active NPI Physical Therapist · Randolph, MA

NPI 1295003804 · NPPES record last updated Dec 31, 2019

Key facts

NPI
1295003804
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
19842 (MA)
Practice address
26 S Main St
Randolph, MA 02368-4821
Phone
(781) 961-9200
Fax
(781) 961-6599
NPI assigned
Dec 9, 2011
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
19842MAMDGeneral Practice Dentistry
PT26996FLMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT26996 FL
Physical Therapist 225100000X 19842 MA Yes

Addresses

Primary practice location

26 S Main St
Randolph, MA 02368-4821

Mailing address

1 Credit Union Way FL 3
Randolph, MA 02368-4633
Phone (781) 961-3370

Other names

  • Chester R Azurin Other name

Other providers in Randolph, MA

All providers in Randolph, MA · Physical Therapist in Massachusetts

Sources for this page

Verify at the official NPI Registry.