Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | DPM00277 | RI |
Y | 222Z00000X | Podiatrist | DPM00277 | RI |
N | 213ES0131X | Foot Surgery | DPM00277 | RI |
NPI | 1427158898 |
---|---|
Provider Name | George M Moniz |
First Address | Warwick, RI 02886-4354 |
Second Address | Warwick, RI 02886-4354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 24/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CP19363 | (05) | RI |
U56193 | (02) |