Provider Demographics
NPI:1578954970
Name:VASQUEZ, ERIN FITZPATRICK (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:FITZPATRICK
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:JO
Other - Last Name:FITZPATRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:441 BISCAYNE DR.
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411
Mailing Address - Country:US
Mailing Address - Phone:315-783-0201
Mailing Address - Fax:910-821-0161
Practice Address - Street 1:441 BISCAYNE DR.
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411
Practice Address - Country:US
Practice Address - Phone:315-783-0201
Practice Address - Fax:910-821-0161
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-07
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14816225100000X
NCP14816225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP14816Medicaid