Individual
MRS. IRINA LOLA GUSINOV
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
100 CUMMINGS CTR, SUITE 207H, BEVERLY, MA 01915-6115
(978) 927-0907
Mailing address
51 TAFT AVE, LEXINGTON, MA 02421-4152
(781) 861-7552
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9318
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0395820
—
MA
Enumeration date
11/08/2005
Last updated
07/08/2007
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