Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MD05964 | RI |
NPI | 1013902816 |
---|---|
Provider Name | Dr. William J Andreoni |
First Address | Johnston, RI 02919-3228 |
Second Address | Johnston, RI 02919-3228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2005 |
Last Update Date | 26/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9002209 | (05) | RI |
C90694 | (02) | RI |