| Doctor Name: | MS. ELAINE M BLECKLEY |
| NPI Number: | 1104817501 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 189296 |
| Business Practice Address: | 223 Chief Justice Cushing Hwy Ste 101 Cohasset, MA - 020251391 |
| Business Phone Number: | 7813836800 |
| Business Fax Number: | 7813836504 |
| Mailing Address: | 223 Chief Justice Cushing Hwy, Ste 101 COHASSET |
| State: | MA |
| Postal Code: | 020251391 |
| Phone Number: | 7813836800 |
| Fax Number: | 7813836504 |
| NPI Enumeration Date: | 11/03/2005 |
| NPI Last Update Date: | 05/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 189296 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |