Healthcare Provider Details

I. General information

NPI: 1235100280
Provider Name (Legal Business Name): ANNA MARIE FLAHERTY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2006
Last Update Date: 10/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ALEXANDER SCAGNELLI, MD, PC 469 CENTERVILLE RD. SUITE 103
WARWICK RI
02886-4335
US

IV. Provider business mailing address

5 PINEWOOD DRIVE
NORTH PROVIDENCE RI
02904-3413
US

V. Phone/Fax

Practice location:
  • Phone: 401-821-4100
  • Fax: 401-823-9180
Mailing address:
  • Phone: 401-559-7384
  • Fax: 401-823-9180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPP 19663
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN00248
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: