Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 5061 | RI |
NPI | 1033130224 |
---|---|
Provider Name | Dr. Mary Ann C Passero |
First Address | Providence, RI 02905-2436 |
Second Address | Providence, RI 02905-2436 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 08/07/2007 |