Provider Demographics
NPI:1639225709
Name:BLANPIED, PETER R (PHD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:R
Last Name:BLANPIED
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 W INDEPENDENCE WAY
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02881-1124
Mailing Address - Country:US
Mailing Address - Phone:401-874-4065
Mailing Address - Fax:401-874-5630
Practice Address - Street 1:25 W INDEPENDENCE WAY
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02881-1124
Practice Address - Country:US
Practice Address - Phone:401-874-4065
Practice Address - Fax:401-874-5630
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI000805225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI409003OtherBLUE CHIP PROVIDER ID
RI64-00196OtherUNITED HEALTH PROVIDER ID
RI7554-9OtherBLUE CROSS PROVIDER ID