Individual
JOANNE COSTANTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
40 HOLLAND ST, SOMERVILLE, MA 02144-2705
(617) 629-6040
Mailing address
147 MILK ST, PROVIDER ENROLLMENT 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8051
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5138
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014438
NEIGHBORHOOD HEALTH PLAN
MA
05
—
0310221
—
MA
01
—
B501027
CIGNA
MA
01
—
HV0001
HARVARD PILGRIM
MA
01
—
Y67467
BLUE CROSS
MA
Enumeration date
03/20/2006
Last updated
04/08/2009
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