Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 125.070028 | IL |
N | 207V00000X | Obstetrician & Gynecologist | DO01084 | RI |
Y | 207VE0102X | Reproductive Endocrinologist | DO01084 | RI |
NPI | 1174054217 |
---|---|
Provider Name | Karine Matevossian |
First Address | Providence, RI 02905-2401 |
Second Address | Providence, RI 02905-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2017 |
Last Update Date | 21/10/2021 |