Provider Demographics
NPI:1851622146
Name:BIELLO, LYNN M (DPT, PT)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:M
Last Name:BIELLO
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:M
Other - Last Name:THERRIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, PT
Mailing Address - Street 1:703 GRANITE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-5350
Mailing Address - Country:US
Mailing Address - Phone:781-961-3370
Mailing Address - Fax:781-961-1291
Practice Address - Street 1:45 FORGE HILL RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-3100
Practice Address - Country:US
Practice Address - Phone:508-541-9111
Practice Address - Fax:508-541-7830
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19051225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9468511OtherAETNA
MA110089739AMedicaid