Provider Demographics
NPI:1730345406
Name:BLASS, BONNIE ROSE (PA-C)
Entity type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:ROSE
Last Name:BLASS
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:673 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-4807
Mailing Address - Country:US
Mailing Address - Phone:856-417-5458
Mailing Address - Fax:
Practice Address - Street 1:241 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2219
Practice Address - Country:US
Practice Address - Phone:978-840-5850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2020-11-02
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical