=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972899177
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FERESHTEH ATTARJAFARI B.S.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/26/2011
-----------------------------------------------------
Last Update Date | 06/26/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1245 BALD HILL RD
-----------------------------------------------------
City | WARWICK
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02886-4233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-821-8283
-----------------------------------------------------
Fax | 401-821-8283
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 85 MARK DR
-----------------------------------------------------
City | NORTH KINGSTOWN
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02852-2427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-821-8283
-----------------------------------------------------
Fax | 401-821-8283
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RPH03470
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PH21576
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------