Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MD07704 | RI |
NPI | 1124027552 |
---|---|
Provider Name | John F Zwetchkenbaum |
First Address | Providence, RI 02906-5026 |
Second Address | Providence, RI 02906-5026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 21/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9002909 | (05) | RI |
E48181 | (02) | RI |