| Doctor Name: | PHILIP A PELLETIER |
| NPI Number: | 1588995468 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSN, NP-C |
| License Number: | RN232943 |
| Business Practice Address: | 821 Main Rd Tiverton, RI - 028781334 |
| Business Phone Number: | 4016251001 |
| Business Fax Number: | 4016251003 |
| Mailing Address: | 821 Main Rd, TIVERTON |
| State: | RI |
| Postal Code: | 028781334 |
| Phone Number: | 4016251001 |
| Fax Number: | 4016251003 |
| NPI Enumeration Date: | 01/17/2010 |
| NPI Last Update Date: | 09/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | RN232943 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |