Basic Information
| Provider Information | |||||||||
| NPI: | 1487917381 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELLAIRS-ROY | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | |||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1351 S COUNTY TRL | ||||||||
| Address2: | SUITE 302 | ||||||||
| City: | EAST GREENWICH | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028185105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4018865663 | ||||||||
| FaxNumber: | 4018849043 | ||||||||
| Practice Location | |||||||||
| Address1: | 1351 S COUNTY TRL | ||||||||
| Address2: | SUITE 302 | ||||||||
| City: | EAST GREENWICH | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028185105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4018865663 | ||||||||
| FaxNumber: | 4018849043 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2012 | ||||||||
| LastUpdateDate: | 05/19/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA4358 | MA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 00649 | RI | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.