Individual ProviderPrema DanielNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address375 Wampanoag Trl, Riverside, RI 02915-2232(401) 649-4010(401) 443-4992PECOS EnrollmentBased on the most recent information from CMS, provider Prema Daniel is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1457786436Provider TypeIndividualFull NameDaniel, PremaCredentialNPGenderFemaleSole ProprietorNoEnumeration Date9/9/2013Last Updated1/7/2022Contact InformationPractice LocationPractice Address375 Wampanoag Trl, Riverside, RI 02915-2232Phone(401) 649-4010Fax(401) 649-4011Mailing LocationMailing Address110 Elm St, Providence, RI 02903-4626Phone(401) 443-4992Fax(401) 784-4902Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN02893Rhode IslandCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseRN2259356Massachusetts