Healthcare Provider Details

I. General information

NPI: 1790782530
Provider Name (Legal Business Name): JAMES E FRENIER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 05/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 CHALKSTONE AVE
PROVIDENCE RI
02908-4728
US

IV. Provider business mailing address

211 QUAKER LN N. CAMPUS BUSINESS OFFICE, ATTN; R. SOARES
WEST WARWICK RI
02893-2151
US

V. Phone/Fax

Practice location:
  • Phone: 401-456-2000
  • Fax:
Mailing address:
  • Phone: 401-270-7077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA0139
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: