Individual
MRS. EVE A GANDOLFO
Active
Individual
MRS. EVE A GANDOLFO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305005996
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770761264
—
VA
01
—
192935
BCBS PHYSICAL THERAPY
VA
01
—
7762447
AETNA
VA
01
—
P00608797
MEDICARE RAILROAD
VA
Enumeration date
02/06/2008
Last updated
05/26/2016
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