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NPI Code Detail

MEDICARE: ANDREA JEAN PARISEAU

MEDICARE: ANDREA JEAN PARISEAU
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist03895RI

General Provider Information

NPI Number : 1255900775
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA JEAN PARISEAU
Provider Business Mailing Address
First Line : 1066 WILLETT AVE
Second Line :
City : RIVERSIDE
State : RI
Zip : 02915-2037
Country : US
Telephone Number : 401-433-5710
Fax Number : 401-433-5713
Provider Business Practice Location Address
First Line : 1066 WILLETT AVE
Second Line :
City : RIVERSIDE
State : RI
Zip : 02915-2037
Country : US
Telephone Number : 401-433-5710
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2021
Last Update Date : 06/19/2021

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Directions to “ ANDREA JEAN PARISEAU ” Practice Location

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