Basic Information
| Provider Information | |||||||||
| NPI: | 1568669869 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PRIMARY CARE OF NORTHERN RHODE ISLAND | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2140 MENDON RD | ||||||||
| Address2: | |||||||||
| City: | CUMBERLAND | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028643833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014755271 | ||||||||
| FaxNumber: | 4014750875 | ||||||||
| Practice Location | |||||||||
| Address1: | 2140 MENDON RD | ||||||||
| Address2: | |||||||||
| City: | CUMBERLAND | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028643833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014755271 | ||||||||
| FaxNumber: | 4014750875 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2007 | ||||||||
| LastUpdateDate: | 09/21/2007 | ||||||||
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| AuthorizedOfficialLastName: | ROBBIO | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | INTERNAL MEDICINE | ||||||||
| AuthorizedOfficialTelephone: | 4014755271 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.