Provider Demographics
NPI:1871534610
Name:FARINE, ANGELA MARIE (PA-C, ATC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:FARINE
Suffix:
Gender:F
Credentials:PA-C, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9872 PEBBLE BEACH COVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 KEANEY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02881-1111
Practice Address - Country:US
Practice Address - Phone:401-874-2051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant