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Individual
DOMENIC F. SULFARO JR.
Active
Individual
DOMENIC F. SULFARO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, LATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
16543
MA
2255A2300X
Athletic Trainer
Primary
624
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0329720
—
MA
01
—
328820
CIGNA
MA
01
—
470490
TUFTS
MA
01
—
626330
HARVARD PILGRIM
MA
01
—
64029
AETNA
MA
01
—
981075
NETWORK HEALTH
MA
01
—
Y68210
BLUE CROSS
MA
Enumeration date
08/31/2006
Last updated
09/26/2007
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