Provider Demographics
NPI:1235278508
Name:ALOQUINA, VIC ANN VISITACION (PT)
Entity Type:Individual
Prefix:MRS
First Name:VIC ANN
Middle Name:VISITACION
Last Name:ALOQUINA
Suffix:
Gender:F
Credentials:PT
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:891 HYDE PARK AVENUE
Mailing Address - Street 2:BOSTON PAIN CLINIC AND PRIMARY CARE
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136
Mailing Address - Country:US
Mailing Address - Phone:617-361-2166
Mailing Address - Fax:617-361-2773
Practice Address - Street 1:891 HYDE PARK AVENUE
Practice Address - Street 2:BOSTON PAIN CLINIC AND PRIMARY CARE
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136
Practice Address - Country:US
Practice Address - Phone:617-361-2166
Practice Address - Fax:617-361-2773
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA7150225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY68089OtherBCBS
MAY68089OtherBCBS