Individual
NATHANAEL PAUL FARRELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
186 PROVIDENCE ST, WEST WARWICK, RI 02893-2508
(401) 615-2800
Mailing address
186 PROVIDENCE ST, WEST WARWICK, RI 02893-2508
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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