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Organization

C O R E PHYSICAL THERAPY CENTERS

Active
Other names
Canoni Corp
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ELIZABETH JEAN CANONI PT,DPT,MS (OWNER)
(781) 388-0012
Entity
Organization

Contact information

Practice address
388 PLEASANT ST, SUITE 305, MALDEN, MA 02148-8143
(781) 388-0012
(781) 388-3312
Mailing address
388 PLEASANT ST, SUITE 305, MALDEN, MA 02148-8143
(781) 388-0012
(781) 388-3312

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11243
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3841105
AETNA HMO NUMBER
MA
01
7703674
AETNA PIN NUMBER
MA
01
820774
TUFTS GROUP NUMBER
MA
01
AA38236
HARVARD PROVIDER NUMBER
MA
01
Y61381
BLUE CROSS GROUP NUMBER
MA
Enumeration date
05/01/2007
Last updated
04/28/2015
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