Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 6644 | MA |
N | 2251E1300X | Electrophysiology, Clinical | 6644 | MA |
N | 2251G0304X | Physical Therapist - Geriatrics | 6644 | MA |
N | 2251N0400X | Physical Therapist - Neurology | 6644 | MA |
N | 2251S0007X | Physical Therapist - Sports | 6644 | MA |
N | 2251X0800X | Physical Therapist - Orthopedic | 6644 | MA |
NPI | 1629200373 |
---|---|
Provider Name | Judy Teitelman |
First Address | Newton, MA 02459-3328 |
Second Address | Newton, MA 02459-3328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2009 |
Last Update Date | 13/08/2009 |