Most Relevant Information
Provider Data
| NPI Number: | 1003383795 |
| Provider Name: | PHINA A MAYU NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | APRN01949 |
Most Important Dates
| Enumeration Date: | 10/31/2018 |
| Last Updated: | 02/16/2020 |
Provider Practice Location
1 RANDALL SQ
PROVIDENCE
RI
029042709
Practice Location Phone/Fax
| Phone: | 4012746339 |
| Fax: | 4014536290 |
Provider Mailing Location
375 ALLENS AVE
PROVIDENCE
RI
029055010
Provider Mailing Phone/Fax
| Phone: | 4014440400 |
| Fax: | 4014440468 |