Provider Demographics
NPI:1427189018
Name:RATTEY, SHARNA B (MSPT)
Entity Type:Individual
Prefix:
First Name:SHARNA
Middle Name:B
Last Name:RATTEY
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SMITHFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-3497
Mailing Address - Country:US
Mailing Address - Phone:401-725-9666
Mailing Address - Fax:401-722-5896
Practice Address - Street 1:2 WAKE ROBIN RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4241
Practice Address - Country:US
Practice Address - Phone:401-333-1747
Practice Address - Fax:401-334-1769
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT02040225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI413951OtherBLUE CROSS BS BLUE CHIP