Provider Demographics
NPI:1487945903
Name:MOONEY, FRANCIS JAMES (PTA/RN)
Entity type:Individual
Prefix:
First Name:FRANCIS
Middle Name:JAMES
Last Name:MOONEY
Suffix:
Gender:M
Credentials:PTA/RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 SEAVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3616
Mailing Address - Country:US
Mailing Address - Phone:401-714-3738
Mailing Address - Fax:
Practice Address - Street 1:30 ROLFE SQ
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-2802
Practice Address - Country:US
Practice Address - Phone:401-784-3714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN40640163W00000X
MARN263756163W00000X
RIPTA00322225200000X
MAPTA4189225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No163W00000XNursing Service ProvidersRegistered Nurse