Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 4444 | RI |
NPI | 1033317524 |
---|---|
Provider Name | Joseph Paul Padayhag |
First Address | Warwick, RI 02886-4462 |
Second Address | Warwick, RI 02886-4458 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C90665 | (02) | RI |