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General NPI Number Information
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NPI Number | 1013694041
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Entity Type | Individual
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Provider Name | SITA ANAJIS AGTERBERG PT
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Gender | Female
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Dates
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Enumeration Date | 06/30/2023
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 1493 CAMBRIDGE ST
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City | CAMBRIDGE
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State | MA
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Zip | 02139-1099
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Country | US
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Telephone | 617-665-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 57 HEDGE RD
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City | BROOKLINE
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State | MA
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Zip | 02445-7512
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Country | US
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Telephone | 414-236-0038
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 26920
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License Number State | MA
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