Provider Demographics
NPI:1932406535
Name:JAAR, PAOLA (DPT)
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:
Last Name:JAAR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 MEDFORD ST STE 303
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-1963
Mailing Address - Country:US
Mailing Address - Phone:617-623-3700
Mailing Address - Fax:617-623-3701
Practice Address - Street 1:265 MEDFORD ST STE 303
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-1963
Practice Address - Country:US
Practice Address - Phone:617-623-3700
Practice Address - Fax:617-623-3701
Is Sole Proprietor?:No
Enumeration Date:2011-02-16
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16357225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1932406535OtherNPI