Jessica Bazar, PT
Individual provider Active NPI Physical Therapist · Pawtucket, RI
NPI 1265720304 · NPPES record last updated Jul 11, 2011
Key facts
- NPI
- 1265720304
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT01281 (RI)
- Practice address
- 727 East Ave
Pawtucket, RI 02860-6184 - Phone
- (401) 365-6800
- Fax
- (401) 365-6939
- NPI assigned
- Jul 11, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT01281 | RI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carlson Therapy Network, PC | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT01281 | RI | Yes |
Addresses
Primary practice location
727 East Ave
Pawtucket, RI 02860-6184
Mailing address
721 Reservoir Ave
Cranston, RI 02910-4430
Phone (401) 946-4250
Other providers in Pawtucket, RI
- Phillip William Bathgate II
- Dayna Bianca Batres
- Benjamin Jared Bauer
- Carol L Baum-Gupta
- Michelle Bliss Bayles
- Peter E Baziotis
- Sarah Lynn Beaudet
- Brenda Beauregard
- Tanya Jean Becker
- Ann Bedard
All providers in Pawtucket, RI · Physical Therapist in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.