Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | DO00478 | RI |
N | 111NI0900X | Internist | DO00478 | RI |
Y | 207RG0100X | Gastroenterologist | DO00478 | RI |
NPI | 1043240062 |
---|---|
Provider Name | Christy Dibble |
First Address | Providence, RI 02905-2401 |
Second Address | Providence, RI 02905-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 17/12/2021 |