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General NPI Number Information
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NPI Number | 1033736970
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Entity Type | Individual
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Provider Name | ALYSSA NATALE FRIEDMAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/26/2020
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Last Update Date | 11/19/2023
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Provider Practice Location Address
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Address Line | 115 JACKSONIA DR
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02911-1224
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Country | US
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Telephone | 401-573-1136
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Fax |
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Provider Business Mailing Address
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Address Line | 115 JACKSONIA DR
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02911-1224
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Country | US
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Telephone | 401-573-1136
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4980
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA7717
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License Number State | MA
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