Organization
FAIRLAWN PRIMARY CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HOLLY FERNANDES (PRESIDENT)
(401) 475-3063
Entity
Organization
Contact information
Practice address
886 MINERAL SPRING AVE, PAWTUCKET, RI 02860-3322
(401) 475-3063
Mailing address
886 MINERAL SPRING AVE, PAWTUCKET, RI 02860-3322
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
09843
RI
363LF0000X
Family Nurse Practitioner
Primary
NPP37132
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7006714
—
RI
05
—
9003461
—
RI
Enumeration date
07/07/2006
Last updated
09/11/2025
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