Facts
- Status
- A
- Credential
- BS, MS
- Type
- Individual
- Enumeration date
- 2026-07-13
- Last updated
- 2026-10-09
Specialties
Licenses
- License RI
- Number not in the file
Location
- Practice location
- 469 CENTERVILLE RD STE 105
- City
- WARWICK RI
- Postal code
- 028864356
- Phone
- 401-773-3700
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.