Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD11912 | RI |
NPI | 1063504512 |
---|---|
Provider Name | Dr. Maria A Guglielmo |
First Address | Warwick, RI 02886-4336 |
Second Address | Warwick, RI 02886-4336 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 12/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9004550 | (05) | RI |
H09842 | (02) | RI |