Individual
MR. RICHARD EMILE FISETTE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
55 LAKE AVE N, ROOM: HA-318, UNIVERSITY CAMPUS, WORCESTER, MA 01655-0002
(774) 443-7552
Mailing address
43 SMITH RD, NEWPORT, RI 02841-1006
(401) 841-4115
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
746014
MA
363A00000X
Physician Assistant
Primary
PA00905
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U400332711
MEDICARE NGS
RI
Enumeration date
09/15/2015
Last updated
12/10/2025
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