Provider Demographics
NPI:1043974686
Name:SODANO, ADRIANA (DPT)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:SODANO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 COLBURN RD
Mailing Address - Street 2:
Mailing Address - City:CHARLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01507-6650
Mailing Address - Country:US
Mailing Address - Phone:508-450-2136
Mailing Address - Fax:508-721-0100
Practice Address - Street 1:198 CHARLTON RD
Practice Address - Street 2:
Practice Address - City:STURBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01566-1571
Practice Address - Country:US
Practice Address - Phone:508-721-0000
Practice Address - Fax:508-721-0100
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21324225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist