Facts
- Status
- A
- Credential
- PharmD
- Type
- Individual
- Enumeration date
- 2022-09-29
- Last updated
- 2022-09-29
Specialties
Licenses
- License RI
- 06282
Location
- Practice location
- 763 TIOGUE AVE
- City
- COVENTRY RI
- Postal code
- 028165805
- Phone
- 401-821-2060
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.