Healthcare Provider Details

I. General information

NPI: 1780316315
Provider Name (Legal Business Name): AMANDA LYNN LAFLAMME PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 MENDON RD
CUMBERLAND RI
02864-3843
US

IV. Provider business mailing address

400 PUTNAM PIKE
SMITHFIELD RI
02917-2408
US

V. Phone/Fax

Practice location:
  • Phone: 401-642-2072
  • Fax:
Mailing address:
  • Phone: 401-757-6160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPT29595
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA01526
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: