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NPI Code Detail

MEDICARE: JOSE A NIEUWENHUIZEN-DONOVAN

MEDICARE: JOSE A NIEUWENHUIZEN-DONOVAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5459MA

General Provider Information

NPI Number : 1588615645
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE A NIEUWENHUIZEN-DONOVAN
Provider Business Mailing Address
First Line : 82 SEMINOLE RD
Second Line :
City : ACTON
State : MA
Zip : 01720-2523
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9 POND LN
Second Line :
City : CONCORD
State : MA
Zip : 01742-2858
Country : US
Telephone Number : 978-369-9996
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2006
Last Update Date : 07/08/2007

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Directions to “ JOSE A NIEUWENHUIZEN-DONOVAN ” Practice Location

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