Basic Information
| Provider Information | |||||||||
| NPI: | 1245219112 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALATALO | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 225 NEW LANCASTER RD | ||||||||
| Address2: | |||||||||
| City: | LEOMINSTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014534958 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9788401900 | ||||||||
| FaxNumber: | 9788401263 | ||||||||
| Practice Location | |||||||||
| Address1: | 225 NEW LANCASTER RD | ||||||||
| Address2: | |||||||||
| City: | LEOMINSTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014534958 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9788401900 | ||||||||
| FaxNumber: | 9788401263 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2006 | ||||||||
| LastUpdateDate: | 05/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 15804 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 0396311 | 01 | MEDICAID WELFARE | OTHER | 042472266 | 01 | PRIVATE HEALTHCARE SYSTEM | OTHER | 042472266 | 01 | THREE RIVERS | OTHER | AA4052 | 01 | HARVARD PILGRIM HEALTHCAR | OTHER | 786723 | 01 | MVP HEALTH CARE | OTHER | 042472266 | 01 | HEALTHCARE VALUE MANAGEME | OTHER | 110020250A | 05 | MA | MEDICAID | Y67988 | 01 | BLUE SHIELD HMO BLUE | OTHER | Y68891 | 01 | MEDICARE B | OTHER | 7327596 | 01 | AETNA US HEALTHCARE | OTHER | Y67988 | 01 | BLUE SHIELD INDEMNITY | OTHER | 2779432 | 01 | CIGNA HEALTH PLAN | OTHER | 47074 | 01 | CHILDRENS MEDICAL SECURIT | OTHER | 042472266 | 01 | ONE HEALTH PLAN | OTHER | 35481155 | 01 | CIGNA HEALTHSOURCE | OTHER | 2779432001 | 01 | CIGNA PAL ID | OTHER | 61611 | 01 | FALLON COMMUNITY HEALTH | OTHER | Y67988 | 01 | BLUE CARE ELECT | OTHER |