Individual
ALICIA BURILLO GORHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0361401
NY
225100000X
Physical Therapist
Primary
21382
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110110058A
—
MA
01
—
1233079
AMERICAN SPECIALTY HEALTH (ASHCIGNA)
MA
01
—
233423
TUFTS HEALTH PLANS- COMMERCIAL PLANS
MA
01
—
4731307
AETNA
MA
01
—
877138
OPTUM/UNITED HEALTH CARE
MA
Enumeration date
08/20/2013
Last updated
04/25/2025
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