Healthcare Provider Details

I. General information

NPI: 1619024130
Provider Name (Legal Business Name): ENT AND ALLERGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 POST RD
WARWICK RI
02886-7140
US

IV. Provider business mailing address

3520 POST RD
WARWICK RI
02886-7140
US

V. Phone/Fax

Practice location:
  • Phone: 401-921-5800
  • Fax: 401-921-2891
Mailing address:
  • Phone: 401-921-5800
  • Fax: 401-921-2891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number StateRI

VIII. Authorized Official

Name: DR. CHARLES S FABER
Title or Position: OWNER AND PROVIDER
Credential: DO
Phone: 401-785-0976