MEDICARE: MS. CHRISTINE SAN ANTONIO P.T.

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	225100000X	Physical Therapist	10125	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y68296	OTHER	MA	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2179597	OTHER	MA	FIRST HEALTH
4	5510520	OTHER	MA	CCN
5	7255570	OTHER	MA	AETNA

General Provider Information

NPI Number	:	1841402310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINE SAN ANTONIO P.T.

Provider Business Mailing Address
First Line	:	350 LINCOLN ST
Second Line	:	SUITE 104
City	:	HINGHAM
State	:	MA
Zip	:	02043-1578
Country	:	US
Telephone Number	:	781-740-4900
Fax Number	:	781-740-4930

Provider Business Practice Location Address
First Line	:	350 LINCOLN ST
Second Line	:	SUITE 104
City	:	HINGHAM
State	:	MA
Zip	:	02043-1578
Country	:	US
Telephone Number	:	781-740-4900
Fax Number	:	781-740-4930

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

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	07/08/2007

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