Lakeside Physical Therapy & Fitness Center

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1953 Issued in NH

Legal business name

LAKESIDE PHYSICAL THERAPY & FITNESS CENTER

Practice address

685 White Mountain Hwy
Tamworth, NH 03886-4625

Phone

(603) 323-2089

Fax

(603) 323-2097

NPI assigned

Feb 11, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jack Tomasz Hadam, DPTNPI 1063594950

Title

DPT/ Owner

Phone

(603) 323-2089

Specialties & licenses 1

Addresses

Tax ID family

Lakeside Physical Therapy and Fitness CT2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lakeside Physical Therapy & Fitness Center

  • Physical Therapist
  • Tamworth, NH
  • NPI 1386957843
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jack Tomasz Hadam, DPT

  • Legal Medicine
  • Tamworth, NH
  • NPI 1063594950
  NPD Authorized official
• Jane Obrero Scienzo, PT

  • Physical Therapist
  • North Conway, NH
  • NPI 1588991830
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1396984670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 WHITE MOUNTAIN HWY",
            "city": "TAMWORTH",
            "state": "NH",
            "postal_code": "038864638",
            "telephone_number": "603-323-2089",
            "fax_number": "603-323-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 WHITE MOUNTAIN HWY",
            "city": "TAMWORTH",
            "state": "NH",
            "postal_code": "038864625",
            "telephone_number": "603-323-2089",
            "fax_number": "603-323-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE PHYSICAL THERAPY & FITNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-11",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "HADAM",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "TOMASZ",
        "authorized_official_title_or_position": "DPT/ OWNER",
        "authorized_official_telephone_number": "603-323-2089",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NH",
            "license": "1953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Tomasz Hadam, DPT
• Mary Kathleen Hanson, OTR/L
• Huggins Hospital
• Brian R Irwin, D.O.
• Lakeside Physical Therapy & Fitness Center
• Lakeview Community Services
• Nancy Sheridan, MSW
• Sheryl Lynn Power, LICSW
• Erika Birch Rezzuti, ABOC
• Tamworth School District

• Physical Therapy Clinic/Center in Tamworth, NH
• Providers in Tamworth, NH by specialty
• Physical Therapy Clinic/Center in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.