Provider Demographics
NPI:1821337106
Name:TEMPESTA, ANTONETTA (PT)
Entity Type:Individual
Prefix:MRS
First Name:ANTONETTA
Middle Name:
Last Name:TEMPESTA
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 1:3 IVY CIR
Mailing Address - Street 2:WELLESLEY
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-4566
Mailing Address - Country:US
Mailing Address - Phone:781-239-2922
Mailing Address - Fax:
Practice Address - Street 1:475 FRANKLIN ST STE 203
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6265
Practice Address - Country:US
Practice Address - Phone:508-309-3450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAH8706PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA225100000XMedicare PIN