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NPI Code Detail

MEDICARE: MRS. COLLEEN D MONTEMARANO PT,MS,DPT

MEDICARE: MRS. COLLEEN D MONTEMARANO PT,MS,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
12251P0200XPediatric Physical Therapist15934MA

General Provider Information

NPI Number : 1548399389
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. COLLEEN D MONTEMARANO PT,MS,DPT
Provider Business Mailing Address
First Line : 24 ARTHUR WOODS AVE
Second Line :
City : BURLINGTON
State : MA
Zip : 01803-2517
Country : US
Telephone Number : 781-272-8518
Fax Number :
Provider Business Practice Location Address
First Line : 10 GILL ST # J
Second Line :
City : WOBURN
State : MA
Zip : 01801-1721
Country : US
Telephone Number : 781-932-2888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 07/08/2007

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