Provider Demographics
NPI:1326299272
Name:PODOLSKAYA, SVETLANA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:PODOLSKAYA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SUDBURY LNDG
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3545
Mailing Address - Country:US
Mailing Address - Phone:508-881-0532
Mailing Address - Fax:
Practice Address - Street 1:24 SUDBURY LNDG
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-3545
Practice Address - Country:US
Practice Address - Phone:508-881-0532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16942225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist