Individual
STEVEN GENDUSO
Active
Individual
STEVEN GENDUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
073
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100073
TUFTS HEALTH PLAN
MA
01
—
Q04320
BCBS OF MA
MA
Enumeration date
12/27/2006
Last updated
07/08/2007
Update your record
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