Egleston Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

232 Issued in MA

Legal business name

EGLESTON PHYSICAL THERAPY

Practice address

1951 Columbus Ave
Roxbury, MA 02119-1048

Phone

(617) 427-8008

Fax

(617) 427-8083

NPI assigned

Dec 8, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Jose Jacob Bobadilla

Title

President

Phone

(617) 427-8008

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260230400000",
    "number": "1730418450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 COLUMBUS AVE",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "02119",
            "telephone_number": "617-427-8008",
            "fax_number": "617-427-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 COLUMBUS AVE",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191048",
            "telephone_number": "617-427-8008",
            "fax_number": "617-427-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EGLESTON PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-08",
        "last_updated": "2009-12-08",
        "status": "A",
        "authorized_official_last_name": "BOBADILLA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "JACOB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-427-8008",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Sharon Ederi
• Linda M Edge
• Ketura'H R Edwards-Robinson, NP
• Michelle Lee Edwards, LCSW
• Catherine Egan, MSW
• Egleston Square Pharmacy,Inc.
• Lakeysha Egleston
• Joyce Einsidler, RPH
• Sulima Elball
• Omar Elbarrag I

• Physical Therapist in Roxbury, MA
• Providers in Roxbury, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; 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.