Adicel Mario Dasilva

Individual provider Active NPI Massage Therapist · Winthrop, MA

NPI 1982292306 · NPPES record last updated Jan 3, 2021

Key facts

NPI
1982292306
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
16273 (MA)
Practice address
120 Winthrop Shore Dr
Winthrop, MA 02152-1237
Phone
(617) 710-2284
NPI assigned
Jan 3, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
16273MAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225700000X 16273 MA Yes

Addresses

Primary practice location

120 Winthrop Shore Dr
Winthrop, MA 02152-1237

Mailing address

120 Winthrop Shore Dr
Winthrop, MA 02152-1237
Phone (617) 710-2284

Other providers in Winthrop, MA

All providers in Winthrop, MA · Massage Therapist in Massachusetts

Sources for this page

Verify at the official NPI Registry.