Provider Demographics
NPI:1679540777
Name:GARAGLIANO, PAUL MICHAEL JR (PTA/L,ATC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:MICHAEL
Last Name:GARAGLIANO
Suffix:JR
Gender:F
Credentials:PTA/L,ATC
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7 LYMAN AVE
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-3044
Mailing Address - Country:US
Mailing Address - Phone:978-568-0894
Mailing Address - Fax:
Practice Address - Street 1:131 COOLIDGE ST
Practice Address - Street 2:STE 222
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749-1331
Practice Address - Country:US
Practice Address - Phone:978-562-0345
Practice Address - Fax:978-562-0257
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA460225200000X
MA772255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer