| Doctor Name: | MR. JERRY CHARLES NEISTADT |
| NPI Number: | 1104027317 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSPT |
| License Number: | 10270 |
| Business Practice Address: | 22 Corey St Melrose, MA - 021764621 |
| Business Phone Number: | 7819793165 |
| Business Fax Number: | 7819793189 |
| Mailing Address: | 72 Danforth Ct, HAVERHILL |
| State: | MA |
| Postal Code: | 018321195 |
| Phone Number: | 9785215386 |
| Fax Number: | |
| NPI Enumeration Date: | 05/29/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 10270 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |