Provider Demographics
NPI:1083437891
Name:BLANDINI, AMY (LCMT, PTA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BLANDINI
Suffix:
Gender:F
Credentials:LCMT, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 ROSS RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824-4219
Mailing Address - Country:US
Mailing Address - Phone:978-764-4648
Mailing Address - Fax:
Practice Address - Street 1:1247 WASHINGTON RD STE 25
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NH
Practice Address - Zip Code:03870-2345
Practice Address - Country:US
Practice Address - Phone:978-494-4339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8116225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist