Provider Demographics
NPI:1740941657
Name:YANARELLA, KRISTEN (PT, DPT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:YANARELLA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 CENTERVILLE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4376
Mailing Address - Country:US
Mailing Address - Phone:401-737-6011
Mailing Address - Fax:401-737-4811
Practice Address - Street 1:3461 S COUNTY TRL STE 304
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1463
Practice Address - Country:US
Practice Address - Phone:401-398-7988
Practice Address - Fax:401-398-7990
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT03439225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist