Provider Demographics
NPI:1023172723
Name:DASILVA, ERIN KELLI (DPT)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:KELLI
Last Name:DASILVA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 SASSAQUIN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-4312
Mailing Address - Country:US
Mailing Address - Phone:401-444-5020
Mailing Address - Fax:401-444-4181
Practice Address - Street 1:765 ALLENS AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-5443
Practice Address - Country:US
Practice Address - Phone:401-444-5020
Practice Address - Fax:401-444-4181
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01853225100000X
MA15081225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY68163OtherBCBSMA