Individual
ALEJANDRA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-5471
Mailing address
2 DUDLEY ST, PROVIDENCE, RI 02905-3236
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01379
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144700
NCCPA ID
—
Enumeration date
10/03/2017
Last updated
03/17/2023
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