MEDICARE: ANTHONY G FARINA JR. MD

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
1	207R00000X	Internal Medicine Physician	RI8466	RI

General Provider Information

NPI Number	:	1679640767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY G FARINA JR. MD

Provider Business Mailing Address
First Line	:	1830 MINERAL SPRING AVE
Second Line	:
City	:	NORTH PROVIDENCE
State	:	RI
Zip	:	02904-3864
Country	:	US
Telephone Number	:	401-351-1900
Fax Number	:	401-270-3080

Provider Business Practice Location Address
First Line	:	1830 MINERAL SPRING AVE
Second Line	:
City	:	NORTH PROVIDENCE
State	:	RI
Zip	:	02904-3864
Country	:	US
Telephone Number	:	401-351-1900
Fax Number	:	401-270-3080

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	12/01/2009

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