Provider Demographics
NPI:1225372477
Name:DE SOUZA, ZELIA N (PT)
Entity Type:Individual
Prefix:
First Name:ZELIA
Middle Name:N
Last Name:DE SOUZA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MARLBORO ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-2121
Mailing Address - Country:US
Mailing Address - Phone:617-335-7906
Mailing Address - Fax:
Practice Address - Street 1:4 MARLBORO ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-2121
Practice Address - Country:US
Practice Address - Phone:617-335-7906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-11
Last Update Date:2012-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11015225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist