IndividualActive
Kenneth Furcolo, PA-C
NPI 1376626440 · Medical Physician Assistant · Providence, RI
Provider details
- NPI number
- 1376626440
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA00067 (RI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
285 Promenade St
Providence, RI 02908-5719
Phone: (401) 459-4001
Fax: (401) 459-4006
Approximate (ZIP-level) locationGet directions
Mailing address
285 Promenade St
Providence, RI 02908-5719
Registry dates
- Enumerated
- 2006-10-23
- Last updated
- 2021-08-19
- Certified
- 2021-08-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.