Provider Demographics
NPI:1437486529
Name:FAY-AZZATO, ERIN (OT)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
Last Name:FAY-AZZATO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:FAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:620 PALMER AVE
Mailing Address - Street 2:UNIT 2
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-5103
Mailing Address - Country:US
Mailing Address - Phone:508-540-5559
Mailing Address - Fax:508-540-5660
Practice Address - Street 1:620 PALMER AVE
Practice Address - Street 2:UNIT 2
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-5103
Practice Address - Country:US
Practice Address - Phone:508-540-5559
Practice Address - Fax:508-540-5660
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3750225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist