Basic Information
| Provider Information | |||||||||
| NPI: | 1295733988 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COTTIERO | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1076 N MAIN ST | ||||||||
| Address2: | STE 3 | ||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029045760 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4018617711 | ||||||||
| FaxNumber: | 4014215710 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 S RANCHO DR STE 12 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891064852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028771887 | ||||||||
| FaxNumber: | 7028774536 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2005 | ||||||||
| LastUpdateDate: | 11/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | RI7743 | RI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | RI7743 | RI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | 19646 | NV | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.