Individual
KATHRYN FALLAVOLLITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
375 WAMPANOAG TRL, RIVERSIDE, RI 02915-2232
(401) 649-4070
(401) 649-4071
Mailing address
DEPT 3010, PO BOX 986524, BOSTON, MA 02298-6524
(401) 443-4992
(401) 537-7241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3383
CT
363A00000X
Physician Assistant
Primary
PA01569
RI
363A00000X
Physician Assistant
PA5430
MA
Other
Enumeration date
07/21/2015
Last updated
07/10/2023
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