Basic Information
Provider Information
NPI: 1538585732
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GIAMMARCO
FirstName: ROSEMARY
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1625 DIAMOND HILL RD
Address2:  
City: WOONSOCKET
State: RI
PostalCode: 028951771
CountryCode: US
TelephoneNumber: 4017621511
FaxNumber: 4017621609
Practice Location
Address1: 1625 DIAMOND HILL RD
Address2:  
City: WOONSOCKET
State: RI
PostalCode: 028951771
CountryCode: US
TelephoneNumber: 4017621511
FaxNumber: 4017621609
Other Information
ProviderEnumerationDate: 03/12/2014
LastUpdateDate: 03/12/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000XLPN04763RIY Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


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