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1710435326 NPI number — STEPHANIE L. DIMINO PT, DPT

NPI Number: 1710435326
Health Care Provider/Practitioner: STEPHANIE L. DIMINO PT, DPT

Information about “1710435326” NPI (STEPHANIE L. DIMINO PT, DPT) exists in 1710435326 in HTML format HTML  |  1710435326 in plain Text format TXT  |  1710435326 in PDF (Portable Document Format) PDF  |  1710435326 in an XML format XML  formats.

NPI Number : 1710435326 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1710435326",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DIMINO",
    "FirstName": "STEPHANIE",
    "MiddleName": "L.",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PT, DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BRACELAND",
    "OtherFirstName": "STEPHANIE",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "39 SIMON ST STE 6",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NASHUA",
    "MailingAddressStateName": "NH",
    "MailingAddressPostalCode": "03060-3046",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "603-417-3976",
    "MailingAddressFaxNumber": "603-589-1211",
    "FirstLinePracticeLocationAddress": "39 SIMON ST STE 6",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NASHUA",
    "PracticeLocationAddressStateName": "NH",
    "PracticeLocationAddressPostalCode": "03060-3046",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "603-417-3976",
    "PracticeLocationAddressFaxNumber": "603-589-1211",
    "EnumerationDate": "09/13/2016",
    "LastUpdateDate": "03/30/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "174400000X",
          "TaxonomyName": "Specialist",
          "LicenseNumber": "22577",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "22577",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "4890",
          "LicenseNumberStateCode": "NH",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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