Individual
JENNIFER MEDEIROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16230
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04 2472266
THREE RIVERS
—
01
—
042472266
PRIVATE HEALTHCARE SYSTEM
—
01
—
2225131
FIRST HEALTH
—
01
—
67906
FALLON COMMUNITY HEALTH P
—
01
—
7353622
AETNA US HEALTHCARE
—
01
—
785960
MVP HEALTH CARE
—
01
—
Y68323
BLUE CARE ELECT
—
01
—
Y69329
MEDICARE B
—
Enumeration date
01/14/2006
Last updated
07/30/2008
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