MEDICARE: KHANH MENDELOWITZ

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
1	225700000X	Massage Therapist	12607	MA

General Provider Information

NPI Number	:	1083069934
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KHANH MENDELOWITZ

Provider Business Mailing Address
First Line	:	648 WASHINGTON ST
Second Line	:
City	:	HANOVER
State	:	MA
Zip	:	02339-2386
Country	:	US
Telephone Number	:	781-826-4600
Fax Number	:

Provider Business Practice Location Address
First Line	:	648 WASHINGTON ST
Second Line	:
City	:	HANOVER
State	:	MA
Zip	:	02339-2386
Country	:	US
Telephone Number	:	781-826-4600
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	MRS. KHANH MENDELOWITZ
Credential	:
Telephone Number	:	617-959-4212

Provider Enumeration Date	:	04/28/2016
Last Update Date	:	04/28/2016

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Directions to “KHANH MENDELOWITZ ” Practice Location

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