Individual
DOMENIC VISOCCHI
Active
Individual
DOMENIC VISOCCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
15414
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
469253
TUFTS
MA
01
—
Y67923
BCBS OF MASS
MA
01
—
Y6860901
MEDICARE P TAN
MA
Enumeration date
07/28/2006
Last updated
05/01/2019
Update your record
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