MEDICARE: PAUL BELLINO DPT

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	2251G0304X	Geriatric Physical Therapist	15974	MA

General Provider Information

NPI Number	:	1467940742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL BELLINO DPT

Provider Business Mailing Address
First Line	:	1023 CHANDLER ST
Second Line	:
City	:	TEWKSBURY
State	:	MA
Zip	:	01876-3713
Country	:	US
Telephone Number	:	978-640-0262
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 FRANCES ST
Second Line	:
City	:	WOBURN
State	:	MA
Zip	:	01801-3006
Country	:	US
Telephone Number	:	781-994-3819
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2018
Last Update Date	:	04/23/2018

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