Basic Information
| Provider Information | |||||||||
| NPI: | 1740560812 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EUGENIO-COLON | ||||||||
| FirstName: | JOSE | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 407 EAST AVE | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | PAWTUCKET | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028605290 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017274800 | ||||||||
| FaxNumber: | 4012735815 | ||||||||
| Practice Location | |||||||||
| Address1: | 1031 BELLEVUE AVE STE 400 | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631171858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3149777455 | ||||||||
| FaxNumber: | 3147812840 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2011 | ||||||||
| LastUpdateDate: | 02/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207V00000X | MD13764 | RI | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.