Provider Demographics
NPI:1215941448
Name:GARRO, CHRISTINE (PA)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:GARRO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:FOLLOWILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 9484
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02940-9484
Mailing Address - Country:US
Mailing Address - Phone:401-854-2500
Mailing Address - Fax:401-854-2519
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-519-1604
Practice Address - Fax:401-272-0538
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICPA00372363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI01/15/2008OtherNHPRI
RI1/15/2008OtherNHPRI
RI9004198Medicaid
RI29688-5OtherBLUECHIP
RI979004198OtherRI MEDICARE
RI1215941448OtherNPI
RI412789OtherBCBSRI
939025129OtherRI MEDICARE GROUP NUMBER
RIP97067Medicare UPIN