NPI 1720482193 · live from the CMS NPI Registry
Blackstone Valley Foot And Ankle INC.
Podiatrist, Foot & Ankle Surgery in Pawtucket, RI. National Provider Identifier 1720482193, active.
NPI record
| NPI | 1720482193 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 345 Armistice Blvd, Pawtucket, RI 02861 |
| Practice phone | 401-725-5576 |
| Enumerated | October 14, 2014 |
| Last updated | April 24, 2017 |
| Authorized official | Joseph Domenico, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | DPM00327 (RI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.