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NPI Code Detail

MEDICARE: MR. JOHN T. PALLOF PT

MEDICARE: MR. JOHN T. PALLOF PT
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
1225100000XPhysical Therapist11390MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Y67843OTHERMABLUE SHIELD
249903OTHERMAFALLON
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4469384OTHERMATUFTS

General Provider Information

NPI Number : 1598737546
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN T. PALLOF PT
Provider Business Mailing Address
First Line : 319A SOUTHBRIDGE ST
Second Line : AUBURN
City : AUBURN
State : MA
Zip : 01501-2598
Country : US
Telephone Number : 508-832-2628
Fax Number :
Provider Business Practice Location Address
First Line : 319A SOUTHBRIDGE ST
Second Line : AUBURN
City : AUBURN
State : MA
Zip : 01501-2598
Country : US
Telephone Number : 508-832-2628
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 07/08/2007

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Directions to “ MR. JOHN T. PALLOF PT” Practice Location

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