Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD15327 | RI |
N | 111NI0900X | Internist | MD15327 | RI |
Y | 207RR0500X | Rheumatology | 278189 | NY |
NPI | 1093000325 |
---|---|
Provider Name | Dr. Kristin J Macdougall |
First Address | Smithtown, NY 11787-2829 |
Second Address | Pawtucket, RI 02860-5290 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2011 |
Last Update Date | 13/05/2020 |