Healthcare Provider Details

I. General information

NPI: 1265931331
Provider Name (Legal Business Name): FAITH ALPICHE FELITTO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2018
Last Update Date: 11/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 BAY DRIVE APT 113
CANTON MA
02021
US

IV. Provider business mailing address

9 BAY DRIVE APT 113
CANTON MA
02021
US

V. Phone/Fax

Practice location:
  • Phone: 617-820-3067
  • Fax:
Mailing address:
  • Phone: 617-820-3067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2282987
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF10181512
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: