Provider Demographics
NPI:1427071877
Name:BLASKO, JESSICA PASKALIS (PT, DPT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:PASKALIS
Last Name:BLASKO
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 1:114 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-6815
Mailing Address - Country:US
Mailing Address - Phone:603-828-9203
Mailing Address - Fax:
Practice Address - Street 1:775 LAFAYETTE RD STE 9
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5434
Practice Address - Country:US
Practice Address - Phone:603-431-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16210225100000X
NH2956225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30393089Medicaid
NH3628198OtherAETNA
NH08Y007532NH01OtherANTHEM
NH30393089Medicaid
NH3628198OtherAETNA