Healthcare Provider Details

I. General information

NPI: 1053802298
Provider Name (Legal Business Name): DIANE KUZIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 05/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 ELLIS AVE
NORWOOD MA
02062-3946
US

IV. Provider business mailing address

6 BERKELEY DR
FRANKLIN MA
02038-1554
US

V. Phone/Fax

Practice location:
  • Phone: 508-949-2331
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7458
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: