Provider Demographics
NPI:1639442825
Name:FURNARI, CAROL ANNE (PA)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANNE
Last Name:FURNARI
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 1:57 CITY HALL AVE
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440
Mailing Address - Country:US
Mailing Address - Phone:978-630-3862
Mailing Address - Fax:978-630-4176
Practice Address - Street 1:57 CITY HALL AVE
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440
Practice Address - Country:US
Practice Address - Phone:978-630-3862
Practice Address - Fax:978-630-4176
Is Sole Proprietor?:No
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA4342363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant