Provider Demographics
NPI:1144791278
Name:SANCHEZ, ERICA M (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:M
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-5035
Mailing Address - Country:US
Mailing Address - Phone:207-831-9365
Mailing Address - Fax:
Practice Address - Street 1:READING MEMORIAL HIGH SCHOOL
Practice Address - Street 2:62 OAKLAND RD
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867
Practice Address - Country:US
Practice Address - Phone:781-944-8200
Practice Address - Fax:781-942-5413
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16352255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1635OtherATHLETIC TRAINER