Provider Demographics
NPI:1528474335
Name:PINTO, TRICIA ANDREA CARMEN (MSPT)
Entity type:Individual
Prefix:MISS
First Name:TRICIA
Middle Name:ANDREA CARMEN
Last Name:PINTO
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 LAKE SHORE CT
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-6369
Mailing Address - Country:US
Mailing Address - Phone:408-807-4687
Mailing Address - Fax:
Practice Address - Street 1:19 LAKE SHORE CT
Practice Address - Street 2:APARTMENT 2
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-6369
Practice Address - Country:US
Practice Address - Phone:408-807-4687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62036168225100000X
MA20913225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist