Individual provider Active NPI

Tanya Marie Pallo, MSPT

  • Physical Therapist
  • Woburn, MA
National Provider Identifier
1225243165
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15404 Issued in MA
Practice address
444 Washington St
Suite 506
Woburn, MA 01801-1046
Phone
(781) 937-9777
Fax
(781) 937-9767
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 15404 MA Primary
Physical Therapist 225100000X 006673 CT

Addresses

Primary practice location

444 Washington St
Suite 506
Woburn, MA 01801-1046

Mailing address

525 Highland Ave
Apt. 45
Malden, MA 02148-3662
Phone (781) 635-5313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006673CTMDProfessional Counselor
15404MAMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225243165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 HIGHLAND AVE",
            "address_2": "APT. 45",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021483662",
            "telephone_number": "781-635-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 WASHINGTON ST",
            "address_2": "SUITE 506",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011046",
            "telephone_number": "781-937-9777",
            "fax_number": "781-937-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLO",
        "first_name": "TANYA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "15404",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "006673",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.