Provider Demographics
NPI:1346721446
Name:WIEGMAN, JULIANA (DPT)
Entity type:Individual
Prefix:DR
First Name:JULIANA
Middle Name:
Last Name:WIEGMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:JULIANA
Other - Middle Name:
Other - Last Name:GALANTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:108 SAWYER AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02125-3630
Mailing Address - Country:US
Mailing Address - Phone:617-600-8071
Mailing Address - Fax:
Practice Address - Street 1:665 BOYLSTON ST STE 3
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-4825
Practice Address - Country:US
Practice Address - Phone:516-745-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043180225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist