Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 158176 | MA |
NPI | 1134195043 |
---|---|
Provider Name | Anthony M Reginato |
First Address | E. Providence, RI 02915 |
Second Address | E. Providence, RI 02915 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 12/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H38106 | (02) |