Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 18020 | MA |
N | 2251S0007X | Physical Therapist - Sports | 18020 | MA |
N | 2251X0800X | Physical Therapist - Orthopedic | 18020 | MA |
NPI | 1194901546 |
---|---|
Provider Name | Melissa Ann Ditaranto |
First Address | Arlington, MA 02474-3820 |
Second Address | Danvers, MA 01923-2121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2008 |
Last Update Date | 16/01/2008 |