Provider Demographics
NPI:1285311498
Name:RICCI, BAILEY ELISABETH (PT, DPT)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:ELISABETH
Last Name:RICCI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 WARNER BROOK DR APT 10104
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-4437
Mailing Address - Country:US
Mailing Address - Phone:401-952-5976
Mailing Address - Fax:
Practice Address - Street 1:300 CROSSINGS BLVD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2878
Practice Address - Country:US
Practice Address - Phone:401-777-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT03683225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist