Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 10035 | MA |
NPI | 1538397013 |
---|---|
Provider Name | Prof. Marianne Beninato |
First Address | Boston, MA 02129-4557 |
Second Address | Boston, MA 02114-3117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2009 |
Last Update Date | 23/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10035 | PHYSICAL THERAPY LICENSE NUMBER (01) | MA |