Individual
MRS. JUDITH S COLANDREO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11089
MA
2255A2300X
Athletic Trainer
1232
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0030419
NEIGHBORHOOD HEALTH PLAN
MA
05
—
0329088
—
MA
01
—
467472
TUFTS PROVIDER NUMBER
MA
01
—
626575
HPHC
MA
01
—
7314479
AETNA/USHC
MA
01
—
Y68488
BC/BS
MA
Enumeration date
11/29/2005
Last updated
07/22/2008
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