Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | RIMD4467 | RI |
NPI | 1033211305 |
---|---|
Provider Name | Dr. Celina A Pereira |
First Address | Kingston, RI 02881 |
Second Address | Kingston, RI 02881 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 08/07/2007 |