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Individual

ALEXANDRIA GERVELIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6 BLACKSTONE VALLEY PL STE 306B, LINCOLN, RI 02865-1112
(401) 334-4021
(401) 334-4886
Mailing address
6 BLACKSTONE VALLEY PL STE 306B, LINCOLN, RI 02865-1112
(401) 334-4021

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01256
RI
363A00000X
Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA01256
STATE LICENSE
RI
01
PA7648
STATE LICENSE
MA
Enumeration date
06/24/2020
Last updated
02/26/2023
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