Healthcare Provider Details

I. General information

NPI: 1326589599
Provider Name (Legal Business Name): ARIELLE FRANCES ILEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 10/04/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 SHREWSBURY ST STE D
HOLDEN MA
01520-1960
US

IV. Provider business mailing address

5 SHREWSBURY ST STE D
HOLDEN MA
01520-1960
US

V. Phone/Fax

Practice location:
  • Phone: 508-829-3800
  • Fax: 508-829-3802
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110005708
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001011589
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA100245
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: