Healthcare Provider Details

I. General information

NPI: 1477603256
Provider Name (Legal Business Name): JENNIFER A ALFAWAZ RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER A POMPOSELLI RN

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 DIAMOND HILL RD STE 18
WOONSOCKET RI
02895-1554
US

IV. Provider business mailing address

PO BOX 746088
ATLANTA GA
30374-6088
US

V. Phone/Fax

Practice location:
  • Phone: 401-470-7116
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPP37388
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: