Provider Demographics
NPI:1366999351
Name:SMALHEISER, ELIOT (PT)
Entity type:Individual
Prefix:MR
First Name:ELIOT
Middle Name:
Last Name:SMALHEISER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:SMALHEISER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7 RESERVOIR RD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-5501
Mailing Address - Country:US
Mailing Address - Phone:978-524-0333
Mailing Address - Fax:
Practice Address - Street 1:7 RESERVOIR RD
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5501
Practice Address - Country:US
Practice Address - Phone:978-524-0333
Practice Address - Fax:978-524-0334
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22431225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist