Provider Demographics
NPI:1548069537
Name:BRADFORD, ERIN K (LE, PMTA)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:K
Last Name:BRADFORD
Suffix:
Gender:F
Credentials:LE, PMTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 POWER RD
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-8625
Mailing Address - Country:US
Mailing Address - Phone:347-543-4598
Mailing Address - Fax:
Practice Address - Street 1:83 POWER RD
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-8625
Practice Address - Country:US
Practice Address - Phone:347-543-4598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RITA00896246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other