Healthcare Provider Details
I. General information
NPI: 1124048905
Provider Name (Legal Business Name): NORTHERN RHODE ISLAND ANESTHESIA ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
115 CASS AVE NORTHERN RHODE ISLAND ANESTHESIA ASSOCIATES, PC
WOONSOCKET RI
02895-4705
US
IV. Provider business mailing address
160 DEDHAM ST
DOVER MA
02030-2225
US
V. Phone/Fax
- Phone: 401-769-4100
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
FATHALL
M
MASHALI
Title or Position: PRESIDENT
Credential: MD
Phone: 401-490-2130