Provider Demographics
NPI:1134505142
Name:FARINELLA, SUZANNE (PA)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:FARINELLA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 EDDIE DOWLING HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:NORTH SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02896-7305
Mailing Address - Country:US
Mailing Address - Phone:401-597-5353
Mailing Address - Fax:401-769-4555
Practice Address - Street 1:65 EDDIE DOWLING HWY
Practice Address - Street 2:
Practice Address - City:NORTH SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02896-7305
Practice Address - Country:US
Practice Address - Phone:401-597-5353
Practice Address - Fax:401-769-4555
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA746008363A00000X
RIPA00997363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant