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NPI Code Detail

MEDICARE: NATHAN RIBEIRO

MEDICARE:   NATHAN  RIBEIRO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant
2363A00000XPhysician AssistantPA01428RI

General Provider Information

NPI Number : 1679162382
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN RIBEIRO
Provider Business Mailing Address
First Line : 32 CHESWORTH ST
Second Line :
City : FALL RIVER
State : MA
Zip : 02723-2507
Country : US
Telephone Number : 508-837-9988
Fax Number :
Provider Business Practice Location Address
First Line : 1524 ATWOOD AVE STE 220
Second Line :
City : JOHNSTON
State : RI
Zip : 02919-3278
Country : US
Telephone Number : 401-272-1900
Fax Number : 401-453-3049
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2021
Last Update Date : 03/19/2026

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Directions to “ NATHAN RIBEIRO ” Practice Location

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