Basic Information
| Provider Information | |||||||||
| NPI: | 1326095175 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FAUCHER | ||||||||
| FirstName: | BRIDGET | ||||||||
| MiddleName: | JEAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1333 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WALPOLE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020811755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086688900 | ||||||||
| FaxNumber: | 5086688901 | ||||||||
| Practice Location | |||||||||
| Address1: | 1333 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WALPOLE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020811755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086688900 | ||||||||
| FaxNumber: | 5086688901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2006 | ||||||||
| LastUpdateDate: | 02/04/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 01999 | RI | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 16930 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 413135 | 01 | RI | BCHIP | OTHER | 31039-8 | 01 | RI | BCBS | OTHER |