Provider Demographics
NPI:1265550198
Name:TASSINARI, MARTHA (PT)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:TASSINARI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:
Other - Last Name:TASSINARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 TREMONT ST
Mailing Address - Street 2:BLDG 11 UNIT 57
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-5304
Mailing Address - Country:US
Mailing Address - Phone:781-934-0100
Mailing Address - Fax:
Practice Address - Street 1:40 TREMONT ST
Practice Address - Street 2:BLDG#11 UNIT 57
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-5304
Practice Address - Country:US
Practice Address - Phone:781-934-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2013-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9939225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist