Individual
KATHERINE W TARANTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1914 CENTRE ST, WEST ROXBURY, MA 02132-2535
(617) 323-8377
(617) 323-8077
Mailing address
1 CREDIT UNION WAY FL 3, RANDOLPH, MA 02368-4633
(781) 961-3370
(781) 961-1291
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
21963
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110146650A
—
MA
01
—
224832
TUFTS
MA
01
—
5850979
AETNA
MA
01
—
P2052593
SENIOR WHOLE HEALTH
MA
Enumeration date
09/06/2015
Last updated
05/03/2019
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