Individual
AMY BERROL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
70 KENYON AVE, SUITE 215, WAKEFIELD, RI 02879-4239
(401) 783-0084
(401) 782-0005
Mailing address
10 DAVOL SQ, SUITE 400, PROVIDENCE, RI 02903-4754
(401) 421-4000
(401) 272-1456
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00182
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
709004434
GROUP MEDICARE
RI
05
—
9003699
—
RI
05
—
9003699
—
SC
01
—
979003699
MEDICARE
—
Enumeration date
09/14/2005
Last updated
09/16/2013
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