Individual
MR. DIMITRIOS GOULAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
41 POPLAR ST, ROSLINDALE, MA 02131-2505
(617) 323-8013
(617) 323-8014
Mailing address
41 POPLAR ST, ROSLINDALE, MA 02131-2505
(617) 323-8013
(617) 323-8014
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8791
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022742
NEIGHBORHOOD HEALTH
MA
05
—
0311847
—
MA
01
—
37992
HARVARD PILGRIM
MA
01
—
409838
TUFTS
—
01
—
Y67509
BC&BS
MA
Enumeration date
04/20/2007
Last updated
07/08/2007
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