Individual
FADYA ELRAYESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 BREWSTER STREET, PAWTUCKET, RI 02860
(401) 729-2206
(401) 729-3495
Mailing address
111 BREWSTER STREET, WOOD BLDG #516, PAWTUCKET, RI 02860
(401) 729-3481
(401) 729-2721
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD10082
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001820702
MEDICARE PTAN
RI
05
—
7007208
—
RI
05
—
900451
—
RI
Enumeration date
08/31/2006
Last updated
03/22/2012
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