Provider Demographics
NPI:1518482306
Name:BILAZZO, JOHN J (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:BILAZZO
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-6121
Mailing Address - Country:US
Mailing Address - Phone:781-248-5046
Mailing Address - Fax:
Practice Address - Street 1:146 PARK AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-5829
Practice Address - Country:US
Practice Address - Phone:781-248-5046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10212225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist