Provider Demographics
NPI:1073973970
Name:INTERLINI, DAVID ANTHONY (PA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ANTHONY
Last Name:INTERLINI
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:116 1/2 GEORGE WATERMAN RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919
Mailing Address - Country:US
Mailing Address - Phone:401-255-0178
Mailing Address - Fax:
Practice Address - Street 1:285 PROMENADE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-5794
Practice Address - Country:US
Practice Address - Phone:401-459-4001
Practice Address - Fax:401-459-4006
Is Sole Proprietor?:No
Enumeration Date:2016-03-04
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIPA00867363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant