Provider Demographics
NPI:1265455687
Name:PALATOV, NATALYA (PT)
Entity Type:Individual
Prefix:
First Name:NATALYA
Middle Name:
Last Name:PALATOV
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 1:345 BISHOPS FOREST DR
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02452-8805
Mailing Address - Country:US
Mailing Address - Phone:617-331-1244
Mailing Address - Fax:617-524-1101
Practice Address - Street 1:134-136 DAY ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130
Practice Address - Country:US
Practice Address - Phone:617-524-1100
Practice Address - Fax:617-524-1101
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10882225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY67423OtherBCBS
MA7591478OtherAETNA
MA0703206Medicaid
MA0028490OtherNEIGHBORHOOD HEALTH PLAN
MAAA51648OtherHARVARD PILGRIM HEALTH CA
MA0703206Medicaid