Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 236192 | MA |
N | 208000000X | Pediatrician | MD14371 | RI |
N | 2080P0210X | Pediatric Nephrologist | 236192 | MA |
Y | 2080P0210X | Pediatric Nephrologist | MD14371 | RI |
NPI | 1902001431 |
---|---|
Provider Name | Dr. Robin Amy Kremsdorf |
First Address | Providence, RI 02903-4141 |
Second Address | Providence, RI 02903-4923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 23/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MD14371 | LICENSE (01) | RI |