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NPI 1467135566

NPI 1467135566 : JENNA ALESSIO : CAMBRIDGE, MA

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General NPI Number Information
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    NPI Number           |    1467135566
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    Entity Type          |    Individual 
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    Provider Name        |    JENNA ALESSIO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/08/2023
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    Last Update Date     |    04/11/2024
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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                  |    02139-1047
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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         |    45 W 3RD ST APT 421 
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    City                 |    SOUTH BOSTON
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    State                |    MA
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    Zip                  |    02127-1190
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    Country              |    US
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    Telephone            |    
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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       |    27058
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    License Number State |    MA
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