Individual
ALISON PARDEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
593 EDDY ST, CLAVERICK 2, PROVIDENCE, RI 02903-4923
(401) 854-2504
(401) 854-2519
Mailing address
PO BOX 9484, PROVIDENCE, RI 02940-9484
(401) 854-2500
(401) 854-2519
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00163
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007008098
RI MEDICARE
RI
01
—
01/15/2008
NHPRI
RI
01
—
09/18/2009
BCBS
RI
01
—
1205840808
NPI
RI
05
—
7008098
—
RI
01
—
939025129
RI MEDICARE GROUP NUMBER
RI
Enumeration date
07/28/2006
Last updated
09/18/2013
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