Individual
KRISTINE M FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
135 GOLD STAR BLVD, WORCESTER, MA 01506
(508) 856-9510
(508) 853-1907
Mailing address
630 PLANTATION ST, WORCESTER, MA 01605
(508) 856-9510
(508) 853-1907
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7353
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0318876
MEDICAID/WELFARE
—
05
—
0318876
—
MA
01
—
042472266
HEALTHCARE VALUE MNGEMENT
—
01
—
2779432
CIGNA HEALTH PLAN
—
01
—
2779432001
COGMA A; OD (REFERRAL #)
—
01
—
35481155
CIGNA HEALTHSOURCE
—
01
—
44338
FALLON COMMUNITY HLTH PLN
—
01
—
5238453
AETNA/US HEALTHCARE
—
01
—
650017419
RAILROAD MEDICARE
—
01
—
785954
MVP HEALTH CARE
—
01
—
AA4052
HARVARD PILGRIM HLTHCARE
—
01
—
Y66516
BLUE CARE ELECT
—
01
—
Y69458
MEDICARE B
—
Enumeration date
01/10/2006
Last updated
07/21/2022
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