Provider Demographics
NPI:1093604126
Name:REAMER, FREDERIC GARY
Entity type:Individual
Prefix:
First Name:FREDERIC
Middle Name:GARY
Last Name:REAMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 CAPWELL AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5659
Mailing Address - Country:US
Mailing Address - Phone:401-487-3771
Mailing Address - Fax:
Practice Address - Street 1:51 CAPWELL AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5659
Practice Address - Country:US
Practice Address - Phone:401-487-3771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW03950104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker