Provider Demographics
NPI:1184675019
Name:BLAIS, ERIN MARY (PT)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:MARY
Last Name:BLAIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 WARREN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-1423
Mailing Address - Country:US
Mailing Address - Phone:401-438-0905
Mailing Address - Fax:401-438-0903
Practice Address - Street 1:927 WARREN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1423
Practice Address - Country:US
Practice Address - Phone:401-438-0905
Practice Address - Fax:401-438-0903
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01241225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI007008452Medicare PIN
RI007008452Medicare UPIN
RI407222OtherBLUECHIP RI IND. ID #
RI1454350001OtherDMERC REGION A RI GROUP