Provider Demographics
NPI:1518614767
Name:TODD, ERIC PAUL
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:PAUL
Last Name:TODD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 HARTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02019-1213
Mailing Address - Country:US
Mailing Address - Phone:508-341-4671
Mailing Address - Fax:
Practice Address - Street 1:348 HARTFORD AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02019-1213
Practice Address - Country:US
Practice Address - Phone:508-341-4671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT00995225X00000X
MA6815225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist