RI DEPARTMENF OF CORRECTIONS
Organization (NPI-2)
Active
Physician Assistant, Medical
Provider Information
- NPI Number
1629168901- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 39 HOWARD AVE, CRANSTON, RI, 029203001
- Phone
- (401) 462-2268
- Fax
- (401) 462-2625
Specialties & Taxonomies
Physician Assistant, Medical
Primary License: RI #PA00221