Provider Demographics
NPI:1689918658
Name:MEROLLI, TAMARA MARIA (PT)
Entity Type:Individual
Prefix:MISS
First Name:TAMARA
Middle Name:MARIA
Last Name:MEROLLI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:221 BOSTON POST RD E
Mailing Address - Street 2:SUITE 221
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3527
Mailing Address - Country:US
Mailing Address - Phone:508-481-5519
Mailing Address - Fax:508-481-6106
Practice Address - Street 1:221 BOSTON POST RD E
Practice Address - Street 2:SUITE 221
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3527
Practice Address - Country:US
Practice Address - Phone:508-481-5519
Practice Address - Fax:508-481-6106
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0077014225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT040.0077014OtherPHYSICAL THERAPY LISCENSE