Provider Demographics
NPI:1922058296
Name:BLENNERHASSETT, SHERRI A (OD)
Entity Type:Individual
Prefix:DR
First Name:SHERRI
Middle Name:A
Last Name:BLENNERHASSETT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1277 HARTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-7121
Mailing Address - Country:US
Mailing Address - Phone:401-521-3606
Mailing Address - Fax:401-453-3288
Practice Address - Street 1:1277 HARTFORD AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-7121
Practice Address - Country:US
Practice Address - Phone:401-521-3606
Practice Address - Fax:401-453-3288
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTG00587152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI007005454Medicare ID - Type Unspecified
U40885Medicare UPIN