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Organization

ENT AND ALLERGY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES S FABER DO (OWNER AND PROVIDER)
(401) 785-0976
Entity
Organization

Contact information

Practice address
3520 POST RD, WARWICK, RI 02886-7140
(401) 921-5800
(401) 921-2891
Mailing address
3520 POST RD, WARWICK, RI 02886-7140
(401) 921-5800
(401) 921-2891

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000002640
BLUESHIELD
RI
05
9002640
RI
Enumeration date
01/05/2007
Last updated
07/21/2022
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