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Individual

KEVIN CARBONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.P.T.

Contact information

Practice address
870 MAIN ST, SPRINGFIELD, MA 01103-2105
(413) 734-7277
(413) 734-7879
Mailing address
46 BEECH ST, SPRINGFIELD, MA 01105-1502

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16318
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0035587
NEIGHBORHOOD HEALTH PLAN
MA
05
0322211
MA
01
043171699
CIGNA
MA
01
704317
CONNECTICARE
MA
01
Y68191
BLUECROSS/BLUESHIELD
MA
Enumeration date
10/26/2005
Last updated
04/09/2009
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