Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | MD05925 | RI |
NPI | 1013086552 |
---|---|
Provider Name | Dr. Paul Casinelli |
First Address | Providence, RI 02904 |
Second Address | Cranston, RI 02920-3722 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 25/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F53806 | (02) | |
PE05925 | (05) | RI |