Provider Demographics
NPI:1912393497
Name:CIMINI, JOHN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:CIMINI
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 1:155 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01105-2010
Mailing Address - Country:US
Mailing Address - Phone:413-732-6005
Mailing Address - Fax:413-732-2334
Practice Address - Street 1:155 UNION ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01105-2010
Practice Address - Country:US
Practice Address - Phone:413-732-6005
Practice Address - Fax:413-732-2334
Is Sole Proprietor?:No
Enumeration Date:2015-04-10
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15226172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker