Organization
GAMBARU CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOLORES I KERSHAW OTR/L (PRESIDENT)
(781) 558-9565
Entity
Organization
Contact information
Practice address
999 BROADWAY, SUITE 100, SAUGUS, MA 01906-4521
(781) 558-9565
Mailing address
999 BROADWAY, SUITE 100, SAUGUS, MA 01906-4521
(781) 558-9565
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251H1300X
Human Factors Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0324621
—
MA
Enumeration date
04/07/2011
Last updated
04/07/2011
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