Ed Blair, ATC
Individual provider Active NPI Athletic Trainer · Storrs, CT
NPI 1326528852 · NPPES record last updated Aug 15, 2018
Key facts
- NPI
- 1326528852
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 000639 (CT)
- Practice address
- 2111 Hillside Rd Unit 3204
Storrs, CT 06269-9179 - Phone
- (860) 486-3046
- NPI assigned
- Aug 15, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 000639 | CT | Yes |
Addresses
Primary practice location
2111 Hillside Rd Unit 3204
Storrs, CT 06269-9179
Mailing address
2111 Hillside Rd Unit 3204
Storrs, CT 06269-9179
Phone (860) 486-3046
Other providers in Storrs, CT
- Avrie Bassingthwaite
- Brian Patrick Batherson
- Eric Beck
- Avery Bernier
- Krista A Billard
- Catherine A Bochain
- Marisa Lynn Bogdonoff
- Colleen Bonadies
- Lauren Nicole Brinsko
- Bailey Brochu
All providers in Storrs, CT · Athletic Trainer in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2018. 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.