Basic Information
| Provider Information | |||||||||
| NPI: | 1437322427 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STARKENBERG | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | NPP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2140 MENDON RD | ||||||||
| Address2: | STE 1 | ||||||||
| City: | CUMBERLAND | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028643833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014753000 | ||||||||
| FaxNumber: | 4014750875 | ||||||||
| Practice Location | |||||||||
| Address1: | 2140 MENDON RD | ||||||||
| Address2: | STE 1 | ||||||||
| City: | CUMBERLAND | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028643833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014753000 | ||||||||
| FaxNumber: | 4014750875 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2008 | ||||||||
| LastUpdateDate: | 04/10/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | NPP37365 | RI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.